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Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment. 
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Q. That Jonathan is 27 years old
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'C'. Can you explain this answer?

You should never treat patients differently based on their age or any other protected characteristics. This principle is contained in Good Medical Practice which states “You must not unfairly discriminate against patients or colleagues by allowing your personal views [This includes your views about a patient’s or colleague’s lifestyle, culture or their social or economic status, as well as the characteristics protected by legislation: age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex and sexual orientation] to affect your professional relationships or the treatment you provide or arrange”. However, this factor might be considered as his age may affect what treatment is appropriate. Therefore, this factor could be considered but it does not have to be. So, this factor is of minor importance. 

Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment. 
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Q. That Dr Mike knows that Jonathan may die without proper treatment
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'A'. Can you explain this answer?

Dr Mike’s key concern must be the best interest of the patient. This is the principle of beneficence which is one of the four pillars of medical ethics. Doctors must also use the best evidence to provide patient’s with the best quality of treatment, this principle is contained in Good Medical Practice which states “In providing clinical care you must: provide effective treatments based on the best available evidence”. Therefore, as Dr Mike knows Jonathan is not receiving the care which is in his best interests, he must consider this factor. Therefore, this consideration is very important.

Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment. 
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Q. The side effects of chemotherapy and radiotherapy
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'B'. Can you explain this answer?

Taking into accounts the benefits and risks (including side effects) is a key principle of medicine. This principle is outlined in Good Medical Principle which states “You must work in partnership with patients, sharing with them the information they will need to make decisions about their care, including: their condition, its likely progression and the options for treatment, including associated risks and uncertainties” . However, the reason this factor is not very important is because Dr Mike’s professional judgement is that this is the most appropriate treatment option. Therefore, this consideration is important.

James and Kim are two 4th year medical students currently on their hepatology placement. James is making TikToks on the wards, sometimes in the view of patients. Some of the TikToks are making fun of patients talking about alcohol use. Kim can see that some of the patients are looking uncomfortable and she feels that James is acting in an unprofessional manner. 
How important is it to take into account are the following considerations for Kim when deciding how to respond to the situation?
Q. That she feels James is being unprofessional
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'B'. Can you explain this answer?

It is important to express concerns that a colleague is being unprofessional. This is outlined in Good Medical Practice which states “If you have concerns that a colleague may not be fit to practise and maybe putting patients at risk, you must ask for advice from a colleague, your defence body or us”. However, professionalism may be subjective and so this factor would not be considered as important as patient safety. Therefore, this consideration is important.

James and Kim are two 4th year medical students currently on their hepatology placement. James is making TikToks on the wards, sometimes in the view of patients. Some of the TikToks are making fun of patients talking about alcohol use. Kim can see that some of the patients are looking uncomfortable and she feels that James is acting in an unprofessional manner. 
How important is it to take into account are the following considerations for Kim when deciding how to respond to the situation?
Q. That James is filming the TikToks on the ward
  • a)
    important
  • b)
    Very Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'B'. Can you explain this answer?

By making TikToks on the ward, James might be making patients feel uncomfortable, and therefore Kim should act. This is outlined in Good Medical Practice which states, “You must take prompt action if you think that patient safety, dignity, or comfort is or may be seriously compromised.” Filming TikToks that mock patients can severely compromise patient dignity and comfort. Hence, it is very important for Kim to consider this when deciding how to respond.

Sarah is a 3rd year medical student on her GP placement. The first patient in the clinic is a 21-year-old student called Mike who has been diagnosed with epilepsy. The GP informs Mike that he will have to stop driving for now. A few days later, Sarah sees Mike driving a car around campus.
How important is it to take into account are the following considerations for Sarah when deciding how to respond to the situation?
Q. Mike’s right to confidentiality
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'A'. Can you explain this answer?

Confidentiality is a key principle of medical ethics, this is contained within Good Medical Practice which states “You must treat information about patients as confidential. This includes after a patient has died.”  The reason confidentiality is so important is that it forms the basis of trust for the doctor patient relationship, this is outlined in GMC guidelines which state “Trust is an essential part of the doctor-patient relationship and confidentiality is central to this. Patients may avoid seeking medical help, or may under-report symptoms, if they think their personal information will be disclosed by doctors without consent, or without the chance to have some control over the timing or amount of information shared.” (GMC Confidentiality Guidelines, p10). Therefore, this consideration is Very Important.

Sarah is a 3rd year medical student on her GP placement. The first patient in the clinic is a 21-year-old student called Mike who has been diagnosed with epilepsy. The GP informs Mike that he will have to stop driving for now. A few days later, Sarah sees Mike driving a car around campus.
How important is it to take into account are the following considerations for Sarah when deciding how to respond to the situation?
Q. That mike could pose a danger to the public
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'A'. Can you explain this answer?

If someone’s safety is at risk, you have an obligation to ensure you act in a way that protects them. This exception to confidentiality is outlined in the GMC guidelines which states “There are also important uses of patient information for purposes other than direct care… Other uses are not directly related to the provision of healthcare but serve wider public interests, such as disclosures for public protection reasons” . Therefore, this consideration is Very Important.

Sarah is a 3rd year medical student on her GP placement. The first patient in the clinic is a 21-year-old student called Mike who has been diagnosed with epilepsy. The GP informs Mike that he will have to stop driving for now. A few days later, Sarah sees Mike driving a car around campus.
How important is it to take into account are the following considerations for Sarah when deciding how to respond to the situation?
Q. Sarah and Mike are both students at the same university
  • a)
    Very important
  • b)
    Important
  • c)
    Of minor importance
  • d)
    Not important at all
Correct answer is option 'C'. Can you explain this answer?

The fact that Mike goes to the same university as Sarah is largely irrelevant and should not affect your decision making. This is outlined in Good Medical Practice which states “You must not unfairly discriminate against patients or colleagues by allowing your personal views [This includes your views about a patient’s or colleague’s lifestyle, culture or their social or economic status, as well as the characteristics protected by legislation: age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex and sexual orientation] to affect your professional relationships or the treatment you provide or arrange.” However, since they attend the same university, they may have a personal relationship as well as a professional one, so this factor might be considered but it would not be detrimental if it was not. Therefore, this consideration is Of Minor Importance.

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