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Hypothetical "what would you do"s watch

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    What would you do if some guy carried a card saying "do not resuscitate". You were a doctor, he's rushed rushed into A&E, his daughter is with him, and she begs you to not let him die. If you don't resuscitate, a young girl will lose her daddy, if you do, you've broken medical ethics.

    Some woman is raped, she's kept locked up for 8 months, then released. She's pregnant with the rapist's child. It's up to you to grant her an abortion, do you force her to give birth to the child, or abort an almost fully developed child?

    umm I'll think of more, or you add some.
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    what piggy said
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    From what I've learned from Casualty, I think that you have to be well enough to sign the treatment forms to refuse treatment. Thus, as the man can't, his next of kin has to. And since his next of kin would sign it, you have to treat him.

    For the second, I believe that if any woman is pregnant by rape she should be allowed to have an abortion, no matter how late it is. However, if she was within a few days or so of giving birth then it might be better to wait.
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    (Original post by fishpaste)
    What would you do if some guy carried a card saying "do not resuscitate". You were a doctor, he's rushed rushed into A&E, his daughter is with him, and she begs you to not let him die. If you don't resuscitate, a young girl will lose her daddy, if you do, you've broken medical ethics.
    If you spent less time having a life and more time watching ER, like myself, then you would know that this one has been done to death (at least one episode per season normally has a story along this line) :rolleyes:
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    1) Probably resuscitate - holding a piece of paper isn't very reliable.

    2) You can't abort at eight months - it's a child then.
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    (Original post by piginapoke)
    Actually, won't aborting at 8 months be practically like giving birth anyway?
    Yes, except you give birth to a dead baby instead of a live one.
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    (Original post by Lord Huntroyde)
    2) You can't abort at eight months - it's a child then.
    ur right. its illegal (in the uk at least)
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    She could always put it up for adoption if she really didn't want to keep it.
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    I was listening to a progrma on the radio and there was a women who thought a mother should be allowed to have a baby killed after the birth if she decided she didn' want it.

    She was one of these weird extremists though.
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    (Original post by piginapoke)
    If you put it like that it does seem a bit harsh. Maybe they could induce the pregnancy, and if the sprog dies it dies, oh well, and if it doesn't, adoption, happy days.
    Most babies born at eight months live nowdays.
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    1. resuscitate. it would be a different story hearing it from a senior doctor's mouth, but a piece of paper proves nothing if it has no authoirsed sig.

    2. i would ask the mother. she is at risk if she wants to abort at 8 months and will have to bring up a rapists child if she doesnt. its a toughy but its got to be her choice entirely
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    (Original post by piginapoke)
    Its only weird in our nicey nicey caring sharing society though. In the distant past parents have killed children if they weren't going to be useful or it would be impractical, e.g. desert tribes tended to kill off girls as they wouldn't be as productive as boys.
    Yep, but we're supposed to be civilised now
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    (Original post by Lord Huntroyde)
    Yep, but we're supposed to be civilised now
    supposed being the key word
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    (Original post by Lord Huntroyde)
    I was listening to a progrma on the radio and there was a women who thought a mother should be allowed to have a baby killed after the birth if she decided she didn' want it.

    She was one of these weird extremists though.
    Does that include u to say 20 years after giving birth?
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    (Original post by neha p)
    1. resuscitate. it would be a different story hearing it from a senior doctor's mouth, but a piece of paper proves nothing if it has no authoirsed sig.
    if it had an authorised sig, then surely you should allow him to die, especially if it is a well known patient who would be most likely to die naturally within a few days anyway
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    It would be very sick indeed to abort a 8 month old foetus. Premature babies have survived long before 8 months.

    It would be very illegal to abort then. No sane doctor would do it. The baby can always be given up for adoption.
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    (Original post by fishpaste)
    What would you do if some guy carried a card saying "do not resuscitate". You were a doctor, he's rushed rushed into A&E, his daughter is with him, and she begs you to not let him die. If you don't resuscitate, a young girl will lose her daddy, if you do, you've broken medical ethics.
    Respect the wish of the patient.

    (Original post by fishpaste)
    Some woman is raped, she's kept locked up for 8 months, then released. She's pregnant with the rapist's child. It's up to you to grant her an abortion, do you force her to give birth to the child, or abort an almost fully developed child?

    umm I'll think of more, or you add some.
    Why punish the child for the deed of the father? by that point it would survive a premature birth anyway so abortion would be totally unnecessary.
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    1) Hmmm thats really difficult, i guess i may depend on what was wrong with him, like if he had been ill for a while or something then i think you'd have to respect his decision BUT if he'd never been ill before and had just been involved in an accident that had led to him being taken to hospital i think ignoring his order would be the best thing to do. of course in real life there are rules you have to abide by so choice doesn't come into it.

    2) I wouldn't abort the baby, 8 months is waaaay too late for an abortion and the baby at that age is able to survive reasonably easy at that age nowadays. also since she'd have to give birth to the baby either way i think i might be more traumatic and mentally scarring to have to kill a baby, rather than giving it up for adoption to a loving family.
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    If his DNR is all legal and there are valid medical reasons for it (e.g. terminal patient or similar) then I'd get the child out of the room (it shouldn't be watching resus anyway) and obey orders.

    My question is why was she locked up for 8 months, and why couldn't she have had the abortion earlier? It's totally illegal to perform an abortion after 24 weeks (I think 28 if the baby will be severely disabled) - she'd have to give birth to it and have it adopted.
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    (Original post by juno_the)
    From what I've learned from Casualty, I think that you have to be well enough to sign the treatment forms to refuse treatment. Thus, as the man can't, his next of kin has to. And since his next of kin would sign it, you have to treat him.
    No-one can consent on the behalf of an adult, even if they do not have the capacity to consent themselves.

    Legally, a doctor should act in the best interests of the patient - They are protected by common law to carry out interventions which they consider to be in the best interests. Obviously this is difficult and open to interpretation. Even signed 'advanced directives' are not legal documents, but obviously would carry much more credit when a Dr is deciding what to do - In the case of a terminally ill person, I think a Dr would respect these.

    It's wise to include the relatives asking them what the PATIENT would want. However, you shouldn't simply go by what the RELATIVES want.


    I'm on a health care of the elderly rotation at the moment, and there are loads of dilemmas. One to think about is the interventional feeding of patients - should you feed someone by NG tube or a PEG (Tube sticking through abdo into stomach). What happens if relatives want this, but you as the Dr don't consider this to be in the pts best interests? What if a decision is made to stop feeding, and then the patient starts to recover, but patients insist that the patient would NOT want to be fed?
 
 
 
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