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alcohol addiction without parental consent or notification.

In situations where patients are unable to make decisions for themselves, responsibility for those

decisions falls on the next of kin if the patient has no written directives clearly stating their intentions.

The next of kin for a lamed person is their spouse followed by their adult children The next of kin is to

make decisions based on how they believe the patient would have wanted things.

A patient who is competent and not incapacitated has the right to refuse treatment by a physician at

anytime even if that treatment is life-saving. A competent patient understands their situation as well asthe possible consequences of decisions made in that situation.

Patients who are temporarily incapacitated should not be allowed to make important health care

decisions.

No matter how serious or trivial a medical error a physician is ethically obligated to inform a patient

that a mistake has been made. Ethics committees and risk management personnel can assist if a patient

wishes to speak with someone or threatens a lawsuit.

In situations where you need to relay difficult information to a patient, you should take the approach of

immediately informing the patient of the news, giving them a moment to think about the news, and

subsequently explaining what the news means and what their options are. You should always end by

answering any questions the patient may have.

The first step in addressing noncompliant patients is to educate them about the disease being treated,

the risks of not treating this disease, and how interventions can help them avoid or lessen these risks.

The responsibility of the physician who serves in a medical capacity at a sporting event is to protectthe health and safety of the players. The desire of spectators, coaches, or even the athlete that he or she

not be removed from the game should not affect the physicians decision. The physicians judgment

should be guided only by medical considerations.

Advance care planning for end of life issues such as desire for intubation, mechanical ventilation, tube

feedings, parenteral feedings CPR and cardioversion are best initially discussed during outpatient

visits with primary care providers. These decisions must also be readdressed during the admission

process for acute admissions so that medical staff can adhere to the specific wishes of patients.

It is unethical to discuss any information regarding the patients diagnosis, treatment, prognosis, etc

with a physician who is not involved in the patients care. Likewise, the physician should neither

confirm nor deny whether the person of interest is, in fact, a patient.

Disability is a form of assistance provided to workers who can no longer work due to their general

medical condition; it requires certification of disability by a physician. When interacting with difficult

patients, it is best to try to calm them, explain your position and inquire more about what troubles

them by using open-ended questions.

Health care information should be fully disclosed, unless the patient has expressly asked not to be

informed.

The female athlete triad consists of an eating disorder, amenorrhea, and osteoporosis.

If as part of a medical team you have been asked to perform an action that you feel will cause harm to

the patient, it is your ethical obligation to discuss that order with your supervising or colleague

physician who has made the questionable suggestion in order to reach a consensus without involving

the patient or ancillary staff

There are only four situations where disclosure of patient information without the consent of the

patient is allowable: 1. When child, elder or spousal abuse is suspected, 2. When a patient has

sustained gunshot or stabbing injuries, 3. When a patient is diagnosed with a reportable communicable

disease and 4. When a patient threatens to kill or physically harm someone else during their interaction

with the physician and has a reasonable ability to carry out this threat in the near future.

Extra

Typical and atypical antipsychotics are the mainstay of treatment for schizophrenia. They have equal

efficacy in treating schizophrenia and are selected by clinicians based upon side-effect profiles.

Physicians are required by law to report obvious child, spousal or elder abuse to law enforcement

authorities. Additionally, reporting of threats of physical harm made by patients who are capable of

carrying out such threats imminently is allowable and advisable under the Tarasoff decision and

similar laws in many states in the United States.

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In situations where a patient is unable to make their wishes known and they do not have written

documentation of their wishes the responsibility for medical decision making falls on the next of kin.

In the case of a married person the next of kin is the spouse

It is ethical to accept gifts from patients if those gifts are not beyond the means of the physician or

patient, if the gift is not made with the intention to secure preferential treatment, if the gift does not

place the patient or their family in financial hardship, and if the patient is not demented. Gifts can

contribute to a positive doctor-patient relationship; shunning all patients with gifts may make patientsfeel awkward as gift-giving is a normal practice in many cultures.

The religious beliefs of patients should always be respected. A parent has the authority to make all

health care decisions for their minor child unless that child is emancipated. If a parents decisions are

not in the best interests of the child or place the child in imminent danger, then a court order should be

sought by medical practitioners.