forevafrensbear
Regular Member
Are these medical student level interview questions?!! Wow.
Following a tragic accident, a 16-year-old boy is admitted to the Emergency Department. He has lost a lot of blood and is hemodynamically unstable. The boy is informed that a blood transfusion will have to be performed to save his life. Upon further questioning you find out that the patient is a Jehovah’s Witness follower. The boy resists any sort of help until the doctors promise to not give him a transfusion. The doctors eventually give in and make a promise to the patient. Some time later, the boy collapses due to the blood loss and is unconscious. The doctor then makes the decision to give a blood transfusion to the boy.
1. What are the conflict of issues in the passage above?
2. Did the doctor lie? Is it acceptable for the doctor to do so if the patient benefits?
3. Where may personal beliefs create an obstacle in the treatment of a patient, as a medical professional? Discuss.
4. Do you think that there is an inter-relation between a persons beliefs and health/wellbeing?
5. How would you have managed the situation?
1. The conflict is that:
A. The patient is identified as a Jehova's Witness and for religious reasons has refused consent for a blood transfusion. He requires a blood transfusion urgently for clinically life-saving reasons. Hence the treating practitioner has to decide whether to give blood knowing that is in conflict with the patient's wishes in order to provide life sustaining treatment.
B. Don't make promises you cannot keep. The statement of a mistruth places the practitioner in a difficult situation where he/she risks breaching the trust of the patient. The ideal situation would be to listen to the patient ; acknowledge his wishes. But not to make a promise. Is it acceptable? That can be argued either way and will be dependent on the reasoning behind the answer.
C/D. This is a 'personal' answer and relies upon reflection of one own's values and how it may affect their thought processes in this case.
E. The patient is a minor. Whilst I would endeavour to respect his wishes as best as able, in the circumstance where there is a time critical need to transfuse blood products emergently in order to save life, the legal precedent in this circumstance is that the practitioner is allowed to do so. An exceptional candidate would be aware of the legal policy/precedent. This situation would ideally require discussion with the executive on-call and/or most senior practitioner on duty in the ED. A patient who collapses would be an ED Resus code -> so I would also briefly mention the BLS/ALS pathway (e.g. DRABC etc...). I would give part of my answer to 'B' and then discuss how I would manage the emergent situation.
There is literature on blood refusal in minors and most institutions will have a well established escalation policy in place.
Following a tragic accident, a 16-year-old boy is admitted to the Emergency Department. He has lost a lot of blood and is hemodynamically unstable. The boy is informed that a blood transfusion will have to be performed to save his life. Upon further questioning you find out that the patient is a Jehovah’s Witness follower. The boy resists any sort of help until the doctors promise to not give him a transfusion. The doctors eventually give in and make a promise to the patient. Some time later, the boy collapses due to the blood loss and is unconscious. The doctor then makes the decision to give a blood transfusion to the boy.
1. What are the conflict of issues in the passage above?
2. Did the doctor lie? Is it acceptable for the doctor to do so if the patient benefits?
3. Where may personal beliefs create an obstacle in the treatment of a patient, as a medical professional? Discuss.
4. Do you think that there is an inter-relation between a persons beliefs and health/wellbeing?
5. How would you have managed the situation?
1. The conflict is that:
A. The patient is identified as a Jehova's Witness and for religious reasons has refused consent for a blood transfusion. He requires a blood transfusion urgently for clinically life-saving reasons. Hence the treating practitioner has to decide whether to give blood knowing that is in conflict with the patient's wishes in order to provide life sustaining treatment.
B. Don't make promises you cannot keep. The statement of a mistruth places the practitioner in a difficult situation where he/she risks breaching the trust of the patient. The ideal situation would be to listen to the patient ; acknowledge his wishes. But not to make a promise. Is it acceptable? That can be argued either way and will be dependent on the reasoning behind the answer.
C/D. This is a 'personal' answer and relies upon reflection of one own's values and how it may affect their thought processes in this case.
E. The patient is a minor. Whilst I would endeavour to respect his wishes as best as able, in the circumstance where there is a time critical need to transfuse blood products emergently in order to save life, the legal precedent in this circumstance is that the practitioner is allowed to do so. An exceptional candidate would be aware of the legal policy/precedent. This situation would ideally require discussion with the executive on-call and/or most senior practitioner on duty in the ED. A patient who collapses would be an ED Resus code -> so I would also briefly mention the BLS/ALS pathway (e.g. DRABC etc...). I would give part of my answer to 'B' and then discuss how I would manage the emergent situation.
There is literature on blood refusal in minors and most institutions will have a well established escalation policy in place.
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