musiclover
Forum Junior
Topics: 13
Posts: 35
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G'day everyone
I am struggling with the "what would you say/do next-type" questions so I have tried to come up with a few rules. Could someone please comment/add?
1. The patient and their wishes come first. Only a few exceptions.
They are a minor: everyone who is not:
over 18, or
married, or
in the army,
Alternatively, between 16 and 18 and seeking emergency treatment, treatment for STD, substance abuse or ?termination of pregnancy (not sure about that).
2. Confidentiality rules except:
Significant threat of harm to others
Reportable disease
3. Never leave the patient or refer them on to someone else (ON USMLE), nor refer to court, family consensus or hospital ethics committee.
4. In end of life decisions, the patient's wishes are the priority. So, the most powerful tool for knowing their wish is an enduring power of attorney (that person can make a decision like they are the patient), then a living will, then an oral directive if it has been given on several occasions and is consistent over time.
5. DNR only applies to CPR. But, I am not sure about something. If a DNR p comes in with a pneumonia, do you give him antibiotics?
6. Seeking information is sometimes a good option especially if someone is REFUSING something because in order for them to refuse something they need to be informed therefore you need to know what their understanding is. Other times you need to make a decision on USMLE questions.
7. It is ok not to tell someone something (eg cancer diagnosis), if they are informed as to the risks of not being told and they have given that directive.
8.You should remove the onus from the patient if possible. Eg tell their family to leave, don't ask. Then they can ask for them to stay. Confidentiality rules.
OK......what do you all think?
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| mani
Forum Guru
Topics: 104
Posts: 1,403
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about 5. u will give antibiotics
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| mjl1717
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#1--If older then 13 years and taking care of self, i.e. living alone, treat as adult.
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| musiclover
Forum Junior
Topics: 13
Posts: 35
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hi mjl,
Thanks (as always) for your response. I have a question about the 13-year-old, though.
In kaplan qbank it says that a girl under 18 is still a minor even if she has a child of her own (if she is unmarried).
Secondly, can a girl get a termination of pregnancy if under 18 without parental permission?
Thanks
H
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| VM
Forum Junior
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if the girl under 18 lives with her parents(not married) and not self sufficient then whether she has a baby or not she is not emancipated.
NO she cant get MTP if she is under 18 and not emancipated.
VM
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| mjl1717
Forum Hero
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According to Kaplan behavioral science -If she lives alone and is over age 13 she is emancipated.
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Smell the coffee! "Is That an Osler move??"
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| musiclover
Forum Junior
Topics: 13
Posts: 35
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oh ok - the girl in the behav schi q I was referring to prob lived with her parents - the significance of which I have now learnt. So many things to know!
unmarried mum living on her own under 18 would be emancipated?
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| mjl1717
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yes
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| mani
Forum Guru
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according to BRS behvioral science, every person living independently is emancipated no matter whats the age
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