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legal qs

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MAGY17
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10/25/07 - 09:25 AM

a pregnant woman 28 weeks of gestation, has down syndrome and preeclampsia severe, refuse to interrupt the pregnant, what to do?

Doc750
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10/25/07 - 10:29 AM

if she is legally competent then you do as she says. If she has a severe MR, and is not legally competent to make her own decisions, then you do what the legal gaurdian says.

If you don't ask her what to do until she begins to seize and is unconscious, then you can do whatever you want. grin

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NE
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10/29/07 - 01:33 PM

Competent woman - she has the right to decide about herself and about UNBORN baby!

MAGY17
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10/29/07 - 06:18 PM

l`m too confused because when pcte go into eclampsia the doctor need to take action, and of course will be delivery.

MAGY17
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10/30/07 - 04:30 PM

in case of intrauterine growth retardation, presence of oligohydramnios is an indication for delivery but de delivery will be vagynal or c- seccion? please

Doc750
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10/31/07 - 07:54 AM

Once you establish legal compitance for a pt, you have to respect their wishes.

An unborn infant has no legal rights until he/she is out of the womb

side note: unless of course you do something to kill it, and then you get charged with murder, (now all of sudden the fetus is recognized as a person and it has rights when its dead) which is usually reduced to manslaughter. Doesn't make any sense to me, but it is, what it is. I doubt this point is on USMLE, so don't worry about it.

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claudia_i
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11/24/07 - 10:04 PM

From Dr. Fisher's ethics book:

"Informed Consent for a Never-Competent Person

If the patient has Down syndrome and has a family member to make decisions for her, then the question is straight forward - ask for the consent of the parent or guardian. If there is no parent or guardian ... a third-party court designee must make a decision based on the best interest of the patient even though the patient may never have expressed the feelings before."

Edited by claudia_i on 11/24/07 - 10:27 PM

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fandarast
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11/25/07 - 12:23 AM

claudia is right.

P.S. Fisher's ethics book is a very good source for the USMLE takers.

me007
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11/25/07 - 02:35 PM

fandarast wrote:
claudia is right.

P.S. Fisher's ethics book is a very good source for the USMLE takers.

Yes, but you have to understand the question.
It is not clear about this particular pt if she is never-competent person.

fandarast
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11/26/07 - 07:38 AM

#10

Absolutely! A question should be understood to be answered appropriately but this one is very vague and I don't think this kind of "invalid" stem will appear on the real exam.

Although, in this case, we can follow Kaplan ethics' rule and "assume that the patinet is competent unless clear behavioral evidence indicates otherwise", because a diagnosis by itself tells us little about patient's competence.

MAGY17
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11/27/07 - 04:51 PM

#11

sorry but the down syndrome here is the fetus not the mother.

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