4th year medical students King Fahd Medical College Riyadh 5th April 2010 Professor Omar Hasan Kasule
Please choose the most appropriate response to each item and give your reasons for the choice
1. You become aware, by accident, that one of the patients is secretly is HIV-
positive (the laboratory report somehow became stuck to the underside of an
envelope he gave to you). Do you
A. tell his spouse about his condition and warn her to be careful?
B. inform your patient that you learned about his HIV by accident, and ask him if he is seeking treatment?
C. make sure that when you treat him, you wear a mask and gloves, and warn other members of the health team to do the same?
D. carries on as normal, saying nothing about it?
2. A number of alternative treatments for your patient are possible. The one which promises the best outcome is also the most expensive and it also carries the most risks. In respect of a patient who is established not to be wealthy, do you
A. explain the costs but omit to emphasize the risks?
B. explain both the risks and the expenses involved?
C. advise a cheaper but possibly less effective treatment?
D. give the patient a written list of treatments and their costs and ask him to make up his own mind?
3. The health team is doing blood grouping, among other tests and you become aware, from the records, that a friend of yours, also a patient, cannot be the biological father of the child he is bringing up. Do you
A. do nothing?
B. warn your friend about the non-paternity?
C. amend the records so that the truth is forever concealed?
D. ask your supervisor what to do?
4. While working in the clinic, it is becoming obvious to you that a number of patients are pretending to be ill, to obtain time off work. You overhear conversations in which they admit to doing second jobs during their medical leave, like driving taxis and selling insurance. Do you
A. warn the doctor concerned?
B. argue with the patients whose conversations you have overheard?
C. contact the police?
D. do nothing?
5. A member of your team is giving powdered peach stones, free, to the patients, because he believes that this prevents cancer. You have reliable information that the peach stone powder is toxic (in fact it can generate cyanide in the stomach). You have argued with your colleague about this but he is adamant that he is only doing good. Do you
A. continue to argue with your colleague in the hope of persuading him that he is misguided?
B. report your concerns to the team leader?
C. go directly to the Ministry of Health with your concerns?
D. write to the New Straits Times about your concerns?
6. Consider the term “patient autonomy”. Do you take it to mean that
A. each patient has individual characteristics?
B. a patient’s own choice of treatments and possible outcomes must be
respected?
C. patients must be regarded as valuable human beings?
D. the patient must automatically follow the best advice given to him?
7. In normal circumstances patients register at your reception area and are told to wait before being called in to see you. You gently move a patient’s head for a better examination but she says that you twisted her neck and complains to the police. Are you protected by the
A. fact that the police will not take up the case?
B. lawyers that your clinic will hire?
C. legal doctrine of implied consent?
D. the sum of money which will be given to the patient in compensation?
8. If for a certain procedure involving physically manipulating the patient, written consent is necessary, but you fail to obtain this and go ahead, are you legally liable in
A. battery?
B. negligence?
C. recklessness?
D. carelessness?
9. A six-year old boy is brought to your clinic for a simple procedure. However you notice multiple bruises on his back and the backs of his arms. The father who accompanies him appears have identifiable needle marks on his arms. Do you
A. demand from the father an explanation of how the bruises occurred.
B. telephone the police immediately with your suspicions.
C. immediately after the end of the consultation, telephone the Society for the
Protection of Children (assuming one exists in your area).
D. note down the address of the family and watch the house for a few hours in the
evening?
10. Running your own clinic/ dispensary, you are asked for a certain treatment by a fifteen year old boy. However you aware that his parents violently disagree with the treatment, which however in your opinion will increase the boy’s ability to benefit from his schooling. Reasoning with the parents has had no effect. Do you
A. contact several colleagues in the same specialty and ask them what they would
do?
B. seek legal advice?
C. merely proceed with the treatment?
D. ask the boy to go elsewhere?
11. A non-urgent procedure is needed for a six-year old boy. However seemingly the boy cannot sit still long enough for the treatment to proceed. Trying to settle him forcibly with the help of his parents causes him to become hysterical and to start kicking and screaming. You noticed that in the waiting room he was continually climbing over the chairs and running round the table. Do you
A. refuse to waste time with the boy?
B. tell the parents how to get psychiatric help?
C. ask the parents to restrain the boy with leather straps so that you can proceed?
D. inform the parents that the child has attention deficit hyperactivity disorder
(ADHD).
12. A 16-year old girl has been your patient for some time, but has been very difficult. At this session she tells you that she is in love with you and wishes to elope with you. Do you
A. immediately send her away and refuse further treatment altogether?
B. call her parents and ask them to reason with her?
C. tell her not to be silly and ask her to sit still for the consultation?
D. ignore her comments, call in a chaperone and proceed?
