A 20-year-old woman presents with nausea, fatigue, and breast tenderness. She is sexually active with two partners and occasionally uses condoms during intercourse. A β-hCG urinary test is positive. A transvaginal ultrasound reveals an 8-week fetus in the uterine cavity. The patient is distressed by this news and requests an immediate abortion. Which of the following is the most appropriate step in management?
AExplain the risk and potential harmful effects of the procedure.
BAsk the patient to reconsider and refer her to a social worker.
CAsk the patient to obtain consent from legal guardians.
DAsk the patient to obtain consent from the baby’s father.
EConduct a psychiatric evaluation for mental competence.
A 26-year-old woman is referred to a reproduction specialist because of an inability to conceive. She comes with her husband, who was previously examined for causes of male infertility, but was shown to be healthy. The patient has a history of 2 pregnancies at the age of 15 and 17, which were both terminated in the first trimester. She had menarche at the age of 11, and her menstrual cycles began to be regular at the age of 13. Her menses are now regular, but painful and heavy. Occasionally, she notes a mild pain in the lower left quadrant of her abdomen. Her past medical history is also significant for episodes of depression, but she currently denies any depressive symptoms. Current medications are sertraline daily and cognitive-behavioral therapy twice a week. After reviewing her history, the doctor suggests performing an exploratory laparoscopy with salpingoscopy. He explains the flow of the procedure and describes the risks and benefits of the procedure to the patient and her husband. The patient says she understands all the risks and benefits and agrees to undergo the procedure, but her husband disagrees and insists that he should have the final word because his wife is "a mentally unstable woman." Which of the following is correct about the informed consent for the procedure in this patient?
AThe patient does not have the capacity to make her own decisions because she is taking a psychotropic medication.
BThe decision must be made by both the wife and the husband because of the patient’s mental illness.
CInformed consent is not necessary in this case because the benefit of the procedure for the patient is obvious.
DBecause of the patient’s mental disease, the consent should be given by her husband.
EThe patient can make the decision about the treatment herself because she does not show signs of decision-making incapability.
A 19-year-old man presents to an orthopedic surgeon to discuss repair of his torn anterior cruciate ligament. He suffered the injury during a college basketball game 1 week ago and has been using a knee immobilizer since the accident. His past medical history is significant for an emergency appendectomy when he was 12 years of age. At that time, he said that he never wanted to have surgery again. At this visit, the physician explains the procedure to him in detail including potential risks and complications. The patient acknowledges and communicates his understanding of both the diagnosis as well as the surgery and decides to proceed with the surgery in 3 weeks. Afterward, he signs a form giving consent for the operation. Which of the following statements is true about this patient?
AHe cannot provide consent because he lacks capacity
BHe has the right to revoke his consent at any time
CHis parents also need to give consent to this operation
DHe did not need to provide consent for this procedure since it is obviously beneficial
EHis consent is invalid because his decision is not stable over time
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