A 5-year-old child is brought to the emergency department after being hit by a motor vehicle on the way to school. According to paramedics, the child's right leg was severely crushed in the accident. After evaluation, the physician recommends immediate limb-saving surgery to preserve the leg and prevent complications. However, the parents refuse to consent to the surgery. They explain that they heard about a similar case where a child died after limb-saving surgery, and they believe the procedure might lead to amputation or death. Despite the physician's explanation that the surgery is intended to save the limb, the parents remain adamant in their refusal. What is the next best step?
AContact the next of kin
BAsk for a court order
CTake into account the child’s wishes
DTake the parents' wishes into account
EInform the hospital Ethics Committee, state authority, and child protective services, and obtain a court order to proceed with treatment
A research team develops a new monoclonal antibody checkpoint inhibitor for advanced melanoma that has shown promise in animal studies as well as high efficacy and low toxicity in early phase human clinical trials. The research team would now like to compare this drug to existing standard of care immunotherapy for advanced melanoma. The research team decides to conduct a non-randomized study where the novel drug will be offered to patients who are deemed to be at risk for toxicity with the current standard of care immunotherapy, while patients without such risk factors will receive the standard treatment. Which of the following best describes the level of evidence that this study can offer?
ALevel 1
BLevel 3
CLevel 5
DLevel 4
ELevel 2
A 16-year-old girl comes to the physician for a regular health visit. She feels healthy. She lives with her parents at home. She says that the relationship with her parents has been strained lately because they ""do not approve"" of her new boyfriend. She recently became sexually active with her boyfriend and requests a prescription for an oral contraception. She does not want her parents to know. She smokes half-a-pack of cigarettes per day and does not drink alcohol. She appears well-nourished. Physical examination shows no abnormalities. Urine pregnancy test is negative. Which of the following is the most appropriate next step in management?
ARecommend an oral contraceptive pill
BDiscuss all effective contraceptive options
CConduct HIV screening
DInform patient that her smoking history disqualifies her for oral contraceptives
EAsk patient to obtain parental consent before discussing any contraceptive options
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