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  #1  
Old 01-10-2011
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Medicolegal and Ethics Two puzzling ethical situations

1- A child with Down and severe pneumonia and heart failure. Parents don't want you to treat.

2- A patient who is in a persistant vegetative state is known to say that he wouldn't want to live like that, but his friend who is has durable power of attorney tells you to give maximal medical care.


what we should do ?
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Old 01-10-2011
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1- Don't treat, because parents have the right to make medical decisions for their children, unless it's an emergency. This is not an emergency.

2- Give maximal care. Durable power of attorney provides total control of decision-making for the patient. It even surpasses next of kin, a living will, or an advance directive. It's as if the patient himself is telling you what he needs.
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Old 01-10-2011
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Quote:
Originally Posted by kemoo1985 View Post
1- A child with Down and severe pneumonia and heart failure. Parents don't want you to treat.

2- A patient who is in a persistant vegetative state is known to say that he wouldn't want to live like that, but his friend who is has durable power of attorney tells you to give maximal medical care.


what we should do ?
1. Treat the child with Down Syndrome - parents are not legally allowed to refuse treatment for a serious medical condition for their child, even if the child is disabled in some way.

2. Follow the friend with POA - legal document always trumps rumour. If the patient had an advance medical directive or DNR, that would take precedence over the POA, but a rumour can't.
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Old 01-10-2011
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Quote:
Originally Posted by Haisook View Post
1- Don't treat, because parents have the right to make medical decisions for their children, unless it's an emergency. This is not an emergency.

2- Give maximal care. Durable power of attorney provides total control of decision-making for the patient. It even surpasses next of kin or a living will.
thanks ok what about in first case with down syndrome if we have emergency situation and the baby will dye and parent dont want to treat .
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Old 01-10-2011
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Parents are the supreme authority in the first case, denying their wish is unethical.So do not treat
The Friend with POA is superior with regard to making medical decisions, not treating wud not be just unethical but illegal as well... unless u wanna end up being sued or something. So treat the patient
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Old 01-10-2011
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Quote:
Originally Posted by Haisook View Post
1- Don't treat, because parents have the right to make medical decisions for their children, unless it's an emergency. This is not an emergency.
I don't know - severe pneumonia?
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Old 01-10-2011
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Angry ethical question

1-
Pneumonia in child and old is serious medical emergency i think so we should treat
2-
Follow the friend and give maximal medical care.
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Old 01-11-2011
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My votes - treat the kid and do what the friend says to with the POA. The first one involves not being able to withhold life saving treatment from the kid and the second one involves no clear appreciation of the patients wishes (you don't know if the patient was depressed or suicidal when they said they wish to discontinue care)
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Old 01-13-2011
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Scenario 1- TREAT- you guys seriously don't think a child w/ severe pneumonia and HF would be allowed to walk out of a doctor's care solely upon the behest of his parents do you?

Scenario 2- unless the patient specifically told you, or has put into official documentation his will, follow power of attorney
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Old 11-22-2011
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Quote:
Originally Posted by kemoo View Post
1- A child with Down and severe pneumonia and heart failure. Parents don't want you to treat.

2- A patient who is in a persistant vegetative state is known to say that he wouldn't want to live like that, but his friend who is has durable power of attorney tells you to give maximal medical care.


what we should do ?
any perfect answers??
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  #11  
Old 11-22-2011
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I agree

1- i think first case is given in our Kaplan,,,if the child has low chance of survival,,,don't treat . . .your question suggests
2- encourage the discussion or consensus,,,if it still doesn't happen send it to court . .
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Old 11-22-2011
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Quote:
Originally Posted by gunner0101 View Post
Scenario 1- TREAT- you guys seriously don't think a child w/ severe pneumonia and HF would be allowed to walk out of a doctor's care solely upon the behest of his parents do you?

Scenario 2- unless the patient specifically told you, or has put into official documentation his will, follow power of attorney
I think this is correct
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  #13  
Old 11-22-2011
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for 1st check Kaplan ethics chapter 2nd page
for 2nd answer,,check cornard fischer 100 cases of ethics,,,i don't know the page number . .
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Old 11-23-2011
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Quote:
Originally Posted by kemoo View Post
1- A child with Down and severe pneumonia and heart failure. Parents don't want you to treat.

2- A patient who is in a persistant vegetative state is known to say that he wouldn't want to live like that, but his friend who is has durable power of attorney tells you to give maximal medical care.


what we should do ?
For the first case,if parents are non-willing, then take this matter to the Court and we should get Courts' permission to treat the kid.
For the second case, Haisook is correct!!
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