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Old 10-22-2012
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Arrow Gyrus Daily Questions; Ethics #4

A physician determines that a 40-year-old patient with Down syndrome needs hepatic surgery within 48 hours. When the physician explains this to the patient she points to her stomach and says, "Tummy hurt." At this time the physician should

(A) declare an emergency and operate immediately
(B) ask the patient's parents for permission to operate
(C) consider the patient competent and then operate
(D) get substituted judgment from the patient's parents and then operate
(E) request that the hospital attorney get a court order to determine whether the patient is competent to give consent
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(C) consider the patient competent and then operate ???
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Old 10-22-2012
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i think C..consider the patient competent unless clearly stated in the stem...
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(C) consider the patient competent and then operate

Pt is considered competent thats why procedure is explained to the patient.
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C
If the procedure was explained to him therefore he is competent, like AKNZ stated.
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(B) ask the patient's parents for permission to operate
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Old 10-23-2012
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Anser is E.

It is not clear whether or not this patient with Down syndrome understands enough about her condition to five informed consent.However, since there is time to make this determination the situation is not emergent.Therefore the physician should request that the hospital attorney contact the court which will evaluate the patients competence with input form consultants.

It the judge decides that the patient is competent she herself can give consent.If she is not competent the judge will appoint a a legal guardian to make this decision.This may or maynot be the patent.
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Old 10-27-2012
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So I was reading BRS Behavioral Science and came across this and all of a sudden this question leaped to the front of my mind and I thought I should post here. Now I know that most of you here are near the end of your prep with Step1 prep (that rhymes lol) but for people like me who are only just getting started this stuff is important.

So a physician has to ask for informed consent which includes not only the said physician telling the patient about the surgical procedure/any other intervention but it also includes patient's comprehension of this supposed intervention and his preference or the lack of it for any other alternatives that are placed on the table for discussion by the doctor. Further details can be read on p.234 if anyone is interested. I hope this was an enlightening moment for you guys too as it was for me (about the patient understanding part )
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