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*MEGATHREAD* Interview discussion thread '15-'16

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Reply 260
Original post by The Medic Portal




@The Medic Portal
Do you know when Liverpool will be sending out interviews?
Original post by Gazoula
Yes!!! :smile:


Yeeees!!!:smile:
Reply 262
Original post by temid
Me too. Any suggestions to start?

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Current issues would be the likes of the junior doctors strikes, A&E waiting times, funding through CCGs.

More general would be abortion, euthanasia, immunisations, patient choice vs well being and loads more.

Can we try and add to this, there's so many but would be good to start discussing them to get the ethical juices flowing :smile:
Original post by Dalts
Current issues would be the likes of the junior doctors strikes, A&E waiting times, funding through CCGs.

More general would be abortion, euthanasia, immunisations, patient choice vs well being and loads more.

Can we try and add to this, there's so many but would be good to start discussing them to get the ethical juices flowing :smile:


Ok, I have a question: A patient who suffers from a chronic illness comes up to you (the doctor) and tells you he wants to undergo Euthanasia, how would you respond?
Interview invite came in at 12:01 this morning for Bristol - 10th Dec! :smile: :smile:

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Original post by Lainathiel
Interview invite came in at 12:01 this morning for Bristol - 10th Dec! :smile:

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Wow! Well done! When did you apply?
Reply 266
Original post by cookiemonster15
Ok, I have a question: A patient who suffers from a chronic illness comes up to you (the doctor) and tells you he wants to undergo Euthanasia, how would you respond?


Euthanasia in this case would be active euthanasia. Its about taking an individuals life who is suffering from a great deal of pain.
It would be wrong to administer euthanasia to this patient since as a doctor we are looking to improve an individuals quality of life and not take it. Euthanasia is also illegal in the UK so it was also be against the law.
I would speak to the patient and comfort them. Ask them what is bringing them to think about euthanasia so that I can provide them with the support them need.

Not sure if thats right?! Correct me if im wrong or if i should add anything else to my train of though!
Thanks


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Reply 267
Original post by Dalts
Current issues would be the likes of the junior doctors strikes, A&E waiting times, funding through CCGs.

More general would be abortion, euthanasia, immunisations, patient choice vs well being and loads more.

Can we try and add to this, there's so many but would be good to start discussing them to get the ethical juices flowing :smile:


I have a question!
A 14 year old patient comes into A&E and needs an urgent blood transfusion. You are the junior doc who is about to take her into theatre when her mother walks in telling you to not give her the blood transfusion. How would you react and what would you do?


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Original post by Rp165
I have a question!
A 14 year old patient comes into A&E and needs an urgent blood transfusion. You are the junior doc who is about to take her into theatre when her mother walks in telling you to not give her the blood transfusion. How would you react and what would you do?


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If they are conscious, then you must first assess their competence. If they are competent and confirms that you can do the transfusion, I would not hold off on the transfusion and explain to the Mother once they were settled, why we had to do it. If they are not competent however, you would then have to turn to the Mother and get her consent. If the Mother does not consent, it would be a good idea to sit down with her and discuss why they need it, what the consequences are if they do not have it, and also why the Mother does not want her to have it - this could be due to previous experiences, risk infection, she's a Jehovah witness. If the Mother still refuses, I believe it's then up to the team to make that decision (I could be wrong here) based on beneficence, which will most likely be to proceed with the transfusion.
(edited 8 years ago)
It's the best answer I've heard for that question. You're right. As a doctor we have to respect the autonomy of the patient (one major ethical pillar), so if the patient is conscious enough to give a permission about he transfusion i don't see any reason why not. However, if she isn't then that's the time we have to look for an immediate family member. The mother in this case. She might debate that she's underage (if the patient is conscious) or if she's not conscious the mother will most probably say no. Then this is the time you need to intervene and speak to her (in private) and go down to the root causes why she doesn't want it and explain to her that you sworn to an oath of beneficence (do good, another ethical pillar). Explain the pros and cons so she won't feel intimidated, probably this is now an exemption of patient confidentiality, but you have to explain reasons why. If she still says no, then we can refer it to a multidisciplinary team (MDT). That's my view of it.
And yeah you hit the nail in the head there. Spot on!

Original post by madmed16
If they are conscious, then you must first assess their competence. If they are competent and confirms that you can do the transfusion, I would not hold off on the transfusion and explain to the Mother once they were settled, why we had to do it. If they are not competent however, you would then have to turn to the Mother and get her consent. If the Mother does not consent, it would be a good idea to sit down with her and discuss why they need it, what the consequences are if they do not have it, and also why the Mother does not want her to have it - this could be due to previous experiences, risk infection, she's a Jehovah witness. If the Mother still refuses, I believe it's then up to the team to make that decision (I could be wrong here) based on beneficence, which will most likely be to proceed with the transfusion.
Original post by futureDOCTOR2k15
Got an interview at Exeter on the 14th of March...long way to go but still...thanks for all ur help!


Good morning!

Great news - well done! Now, remember, Exeter do MMI style interviews, so make sure you are aware of what each station could entail, and try and do some mock interviews with your family/friends/teachers!

Don't forget to practice answering the traditional style questions as well, like 'why do you want to study medicine?'. There are often MMI stations on these sorts of questions.

We've got some tools which might help you revise, like our free interview question bank with worked answers you can take a look at. We've also got free blogs written by medical students who've been through the interview process. We hope you find them useful!

Good luck!

The Medic Portal
Reply 271
Original post by madmed16
If they are conscious, then you must first assess their competence. If they are competent and confirms that you can do the transfusion, I would not hold off on the transfusion and explain to the Mother once they were settled, why we had to do it. If they are not competent however, you would then have to turn to the Mother and get her consent. If the Mother does not consent, it would be a good idea to sit down with her and discuss why they need it, what the consequences are if they do not have it, and also why the Mother does not want her to have it - this could be due to previous experiences, risk infection, she's a Jehovah witness. If the Mother still refuses, I believe it's then up to the team to make that decision (I could be wrong here) based on beneficence, which will most likely be to proceed with the transfusion.


I thought if an individual was not competant, it is up to the team to make the descision and not relatives? I might be wrong


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Original post by Rp165
I thought if an individual was not competant, it is up to the team to make the descision and not relatives? I might be wrong


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That would be true if they were classified as an adult, but in this case, they are only 14 years old, and therefore seen as a young person/child. 😊
Original post by Darkangel1979
It's the best answer I've heard for that question. You're right. As a doctor we have to respect the autonomy of the patient (one major ethical pillar), so if the patient is conscious enough to give a permission about he transfusion i don't see any reason why not. However, if she isn't then that's the time we have to look for an immediate family member. The mother in this case. She might debate that she's underage (if the patient is conscious) or if she's not conscious the mother will most probably say no. Then this is the time you need to intervene and speak to her (in private) and go down to the root causes why she doesn't want it and explain to her that you sworn to an oath of beneficence (do good, another ethical pillar). Explain the pros and cons so she won't feel intimidated, probably this is now an exemption of patient confidentiality, but you have to explain reasons why. If she still says no, then we can refer it to a multidisciplinary team (MDT). That's my view of it.
And yeah you hit the nail in the head there. Spot on!


Haha, thank you!
Just to correct one thing I think about the blood transfusion question, you wouldn't take it to the MDT because they, like you, do not have the power to overrule the mum's decision to say no. In this case you would have to take legal action and ask for the court to take an intervention as you are viewing this as child endangerment and that the patient will otherwise pass away and your duty is to your patient not their parent.


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Ah I see... So the court has to decide?
Original post by Hopefulmedic15
Just to correct one thing I think about the blood transfusion question, you wouldn't take it to the MDT because they, like you, do not have the power to overrule the mum's decision to say no. In this case you would have to take legal action and ask for the court to take an intervention as you are viewing this as child endangerment and that the patient will otherwise pass away and your duty is to your patient not their parent.


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Original post by Darkangel1979
Ah I see... So the court has to decide?


Yes essentially, and if they overrule the mum's lack of consent you can go ahead with the transfusion


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Original post by Hopefulmedic15
Just to correct one thing I think about the blood transfusion question, you wouldn't take it to the MDT because they, like you, do not have the power to overrule the mum's decision to say no. In this case you would have to take legal action and ask for the court to take an intervention as you are viewing this as child endangerment and that the patient will otherwise pass away and your duty is to your patient not their parent.


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Are you sure...? By the time legal action is called for and the court intervene, they would probably have died... I would rather be sued for saving a life than losing one. I'm not 100% sure but if it is an urgent blood transfusion they do not have a lot of time. I thought that if a child was incompetent then you would turn to the family, but if they still refuse then you need to decide what is best for that patient (although family consent is very much appreciated)? Can someone else clarify what would happen in this circumstance? You could be right, but I've heard different :smile:

I would completely agree if it was not an urgent interference, but it seems this blood transfusion is needed very quickly.
(edited 8 years ago)
Original post by madmed16
Are you sure...? By the time legal action is called for and the court intervene, they would probably have died... I would rather be sued for saving a life than losing one. I'm not 100% sure but if it is an urgent blood transfusion they do not have a lot of time. I thought that if a child was incompetent then you would turn to the family, but if they still refuse then you need to decide what is best for that patient (although family consent is very much appreciated)? Can someone else clarify what would happen in this circumstance? You could be right, but I've heard different :smile:

I would completely agree if it was not an urgent interference, but it seems this blood transfusion is needed very quickly.


http://www.uhs.nhs.uk/HealthProfessionals/Clinical-law-updates/Young-person-refusing-blood-transfusion.aspx

Save life first, deal with legal issues later :smile:

Note this is if there really is little time! i.e. less than 30 minutes. Because it doesn't take long to get the court order.
(edited 8 years ago)


That's what I thought! Thank you very much :biggrin:

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