Law & Ethics

Question 1 of 8

A 35 year old woman with motor neurone disease is brought into AED moribund with sepsis. It is quickly learned that she has an advance directive (AD) in place that states she does not wish to receive any life-saving treatment if she becomes unwell.
  1. What four factors need to be true for an AD to be legally binding? (2 marks)
  2. The husband, who was appointed Lasting Power of Attorney before the AD was created, wants you to do everything you can to save her. Does this overrule the AD? (1 mark)

Law & Ethics

Question 2 of 8

A 15 year old presents to AED alone asking for emergency contraception.
  1. What does the patient need to demonstrate before you can prescribe emergency contraception? (1 mark)
  2. Name four of the criteria that you must be satisfied of before prescribing the medication. (2 marks)

Law & Ethics

Question 3 of 8

A 4 year old child is brought into AED by mum. His dad arrives later. His parents have divorced in the past year. You suspect the child has meningitis and wish to perform a lumbar puncture. Mum refuses to give consent but dad agrees.
  1. Who is able to consent for a child under 16 years of age? (1 mark)
  2. What two factors give a dad parental responsibility for a child? (2 marks)

Law & Ethics

Question 4 of 8

A 25 year old man is brought into hospital after having a seizure. Tonic clonic seizure activity was witnessed by the paramedics. The patient denies any alcohol or illicit drug consumption. He is otherwise fit and well, with no medical history and no regular medications. A CT scan is performed which is normal. The patient has completely recovered and you have arranged neurology follow-up in the first-fit clinic.
  1. What advice should you give to the patient about driving before discharge? (1 mark)
  2. The patient is a frequent attender over the next few months with further fits. He has been diagnosed with epilepsy by a neurology specialist. You are aware the patient is still driving despite advice from the medical team. How should you proceed? (1 mark)
  3. In a patient with known epilepsy with tonic-clonic seizures, when will the DVLA consider allowing a patient to drive a car again? (1 mark)

Law & Ethics

Question 5 of 8

A 50 year lady with early onset dementia, is brought into hospital with breathlessness by her husband, who has been authorised as her Lasting Power of Attorney (LPA). X-ray shows a large unilateral pleural effusion and you wish to perform a pleural aspiration.
  1. What is an LPA? (1 mark)
  2. Give two situations in which an LPA cannot consent/refuse treatment. (1 mark)
  3. If hospital staff had concerns about decisions made by the LPA, who should these concerns be reported to? (1 mark)

Law & Ethics

Question 6 of 8

A 59 year old homeless man is brought in by ambulance with a painful, offensive smelling, and necrotic left leg. He was found on the floor and persuaded to come into hospital but he is refusing to have any investigations or treatment.
  1. What group of individuals are presumed to have capacity? (1 mark)
  2. Your consultant wishes for you to assess and record overall capacity for this patient. Explain why this is not possible. (1 mark)
  3. What three key principles should be followed when assessing capacity? (1 mark)

Law & Ethics

Question 7 of 8

A 17 year old boy, with known asthma, is brought into AED with a severe asthma attack. The paramedics have started high flow oxygen through a rebreather mask and given him a salbutamol nebuliser. You wish to perform an arterial blood gas to further assess the patient.
  1. At what age is a child presumed to have capacity to consent for their own treatment and care. (1 mark)
  2. Give two methods by which the patient could consent. (1 mark)
  3. Give three possible complications of arterial blood gas sampling. (1 mark)

Law & Ethics

Question 8 of 8

You are asked to give a teaching session on consent to a group of medical students. You decide to create a list of questions to pre-test the students at the start of the session. Create your answers to the following questions:
  1. When consenting an individual for a particular procedure or treatment, give three factors that should be explained to the patient. (1 mark)
  2. Give two situations in which an individual can consent on behalf of another person. (1 mark)
  3. What factors need to be true in order for consent to be considered valid? (1 mark)

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