Which situation would be appropriate to refer to the hospital ethics committee?
Parents are shocked when their child is diagnosed with a malignant bone tumor. The orthopedic surgeon discusses the options of limb amputation and a limb-salvage procedure. The parents are asked to consider each option.
A child in end-stage renal failure is placed on the renal transplant list. The parents are asked to sign permission for surgery after a cadaver kidney is located. One parent is out of town and gives telephone consent.
After initial therapies have failed, a child with leukemia is evaluated for a new cancer protocol. The child, age 8 years, gives assent for the new treatment, and his parents give their consent.
The physician recommends that a young child be taken off the ventilator. The parents, who are divorced and have joint custody of the child, have differing views about whether to discontinue the ventilator.
The Correct Answer is D
Choice A reason: This situation does not require the involvement of the hospital ethics committee, as the parents are not refusing or requesting any treatment that is contrary to the standard of care. The surgeon is providing them with information and options, and the parents are free to make their own decision.
Choice B reason: This situation does not involve any ethical dilemma, as the parents are giving their permission for the surgery, and the telephone consent is legally valid. The hospital ethics committee is not needed to resolve any conflict or uncertainty.
Choice C reason: This situation is an example of ethical research involving children, as the child is giving assent and the parents are giving consent for the new protocol. The hospital ethics committee is not required to intervene, as the research protocol has already been approved by the institutional review board.
Choice D reason: This situation is an appropriate case for the hospital ethics committee, as it involves a life-and-death decision that affects the child's best interests and the parents' rights. The hospital ethics committee can help to mediate the conflict, provide guidance, and facilitate a resolution.
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Related Questions
Correct Answer is B
Explanation
Choice A: True - While it is true that a significant proportion of prisoners have experienced abuse in their childhood, the statement that over half of all violent offenders in prison were physically or sexually abused as children is not accurate according to available data¹²³.
Choice B: False - This is the correct answer. According to a report by the Ministry of Justice in the UK, a large number of prisoners have experienced adverse childhood experiences, but the percentage does not exceed half¹. Similarly, a survey of men in Her Majesty's Prison Parc in South Wales found that more than 8 in 10 had experienced at least one adverse childhood experience, but this includes a range of experiences beyond physical and sexual abuse². Furthermore, data from the U.S. indicates that less than 20% of state prison inmates reported experiencing abuse before the age of 18³.
Correct Answer is A
Explanation
Choice A reason: A peak expiratory flow meter is a device that measures how fast the child can exhale air from the lungs. It can help monitor the severity of asthma and the effectiveness of treatment. It can also help identify triggers and prevent asthma attacks.
Choice B reason: A metered dose inhaler with spacer is a device that delivers medication to the lungs. It can help relieve or prevent asthma symptoms, but it does not measure how well the asthma is controlled.
Choice C reason: Pulse oximetry is a device that measures the oxygen saturation of the blood. It can help detect hypoxia, which is a complication of asthma, but it does not measure how well the asthma is controlled.
Choice D reason: Inhaled steroids are a type of medication that reduce inflammation in the airways. They can help prevent asthma attacks and improve lung function, but they do not measure how well the asthma is controlled.
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