ETHICS SET

ETHICS SET
1. Identify the core ethical principle described by each of the following statements:

a. A physician refuses to administer antibiotics to a patient with a viral infection because of

the high risk of dangerous side effects.
b. A physician allows a cancer patient to choose between two acceptable and equally effective
treatment plans.
c. A competent patient refuses therapy for a life-threatening condition.
d. A working-class patient with end-stage liver disease is given higher priority for a liver
transplant than an internationally-renowned actor whose liver disease is less advanced.

2. A 66-year-old man is undergoing an elective unilateral total knee replacement for

osteoarthritis. He is strongly opposed to receiving blood products due to his religious beliefs,
and has a living will that confirms these wishes. He understood and acknowledged the
risks of refusing blood transfusion when he signed the pre-operative consent form. During
the procedure a large artery is injured and a significant volume of blood is lost. He will not
survive without a transfusion. How should the situation be handled in the operating room,
with the patient under anesthesia?

3. A 61-year-old man is admitted to the hospital for an acute exacerbation of COPD. He

plays golf regularly with the chairman of the cardiology department. At grand rounds, the
cardiologist asks the treating pulmonologist how his friend is doing.
a. Under what circumstances may a physician share a patients confidential information?
b. What is the most appropriate response to the cardiologists request for information?

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ETHICS SET

4. A 76-year-old man comes to the clinic for follow-up of diabetes, hypertension and atrial
fibrillation. He is accompanied by his caregiver, a family friend that spends six days a week
with the patient. Review of the medical record shows that he has not been refilling his
medication as often as he used to. He has had a 4.5-kg (10-lb) weight loss since last year.
Physical examination shows bruising of his arms at different stages of healing. What would
be the most appropriate course of action for this patient?

ETHICS

5. A 12-year-old boy is brought to the emergency department by ambulance with sudden lower
abdominal pain. He is diagnosed with appendicitis and appendiceal perforation, and the
surgical consultant recommends emergency surgery. The boys parents are out of town for
their anniversary and they left his 17-year-old sister in charge. What is the most appropriate
next step in the care of this patient?

6. A 30-year-old homeless man was admitted to the hospital with severe head trauma after
being struck by an automobile. He has been on life support for the last two weeks. There
is no advanced directive or living will on file. Who is authorized to make decisions about
withdrawal of life support?

7. What is the most appropriate ethical response to each of the following situations?

a. A physician orders an invasive test for the wrong patient.

b. A patient tells the physician that he/she finds the physician attractive and wants to start
dating.
c. An elderly woman is found to have inoperable lung cancer, and her family asks the
physician to tell the patient the biopsy was negative.
d. You suspect another physician of practicing while under the influence of alcohol.

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ETHICS SET

8. A 42-year-old woman is diagnosed with symptomatic cholelithiasis and is being evaluated

for an elective cholecystectomy. She has a history of bipolar disorder with psychotic features.
a. Who should determine whether this patient has the capacity to make health care
decisions?
b. What is required to determine if a patient has decision-making capacity?

9. A 17-year-old girl at 21 weeks gestation comes to the clinic to discuss her pregnancy. She
currently lives with her boyfriend and is planning on raising the child herself. The patients
parents have come with her on this visit. They believe she should put the baby up for
adoption. They ask the physician to convince the patient that adoption is best for her future.
What would be the most appropriate course of action?

10. A 73-year-old woman has metastatic breast cancer with a life expectancy of 3 months. She is
in constant pain and is refilling her narcotic pain medication sooner than she should. There
is a remote history of substance abuse and dependence. She asks if she can be prescribed
more pain pills. What should be done for the patient?

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