A 45-year-old man is brought to the emergency department by his friends because of a 1-hour history of shortness of breath and squeezing chest pain. They were at a party where cocaine was consumed. A diagnosis of acute myocardial infarction is made. The physician stabilizes the patient and transfers him to the inpatient unit. Six hours later, his wife arrives at the emergency department and requests information about her husband's condition. Which of the following is the most appropriate action by the physician?
AAsk the wife for a marriage certificate
BInform the wife about her husband's condition
CConsult the hospital ethics committee
DObtain authorization from the patient to release information
ERequest the patient's durable power of attorney document
A 22-year-old man is brought to the emergency department by his friends 30 minutes after falling down a flight of stairs. His friends report that they were at a college party, where he drank large amounts of alcohol. He is aggressive and restless. Examination shows tenderness to palpation and swelling of his right lower leg. An x-ray of the right leg shows a lower tibial shaft fracture. The physician recommends overnight observation and surgery the following morning. The patient refuses the suggested treatment and requests immediate discharge. Otherwise, he says, he will call his lawyer and sue the entire medical staff involved in his care. Which of the following is the most appropriate response by the physician?
AYou can leave the hospital after signing a self-discharge against medical advice form.
BIf you don't consent to treatment, I'll be forced to obtain consent from your parents.
CI understand that you want to go home, but I'll have to keep you here as long as you are intoxicated.
DHave you ever felt you should cut down on your drinking?
EI can't force you to stay here, but I'll have to inform your dean of this incident.
A 62-year-old man comes to his primary care physician with a 3-month history of insomnia and severe work anxiety. He says that he is unable to retire because he has no financial resources; however, the stress level at his work has been causing him to have worsening performance and he is afraid of being fired. He thinks that he would be able to resume work normally if he was able to decrease his level of anxiety. His physician prescribes him a trial 1-month regimen of benzodiazepine therapy and schedules a follow-up appointment to see whether this treatment has been effective. Three weeks later, the patient's wife calls and says "My husband was fired from work and it's your fault for prescribing that medication! I know he must have been taking too much of that drug. Don't you know that he had a horrible problem with drug abuse in his 30s?" Which of the following is the most appropriate first action for the physician to take?
ADischarge the patient for inappropriate use of medication
BContact the physician's medical practice insurance company regarding a potential claim
CRefer the patient to a substance abuse program
DContact the patient directly to discuss the situation
EInform the patient's wife that patient information cannot be disclosed to her due to HIPAA
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