Ethical and Legal Issues in Obstetrics and Gynecology
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Items 486–490 Your patient is a 44-year-old G4P4 with symptomatic uterine fibroids that are unresponsive to medical therapy. The patient has severe menorrhagia to the point that when she gets her menses, she cannot leave the house. You recommend to her that she undergo a total abdominal hysterectomy. You counsel her that she may need a blood transfusion if she suffers a lot of bleeding during the surgical procedure. Her current hematocrit is 25.0. The patient is a Jehovah’s Witness who adamantly refuses to have a blood transfusion, even if it results in her death. 486. All of the following are ethical concerns that need to be considered when working through this case except a. b. c. d.
Legal issues Patient preferences Quality of life issues Medical indications
487. The patient’s insurance company refuses to pay for the surgical procedure. The ethical area involved is a. b. c. d. e.
Autonomy Justice Contextual issue Patient preference Quality of life
488. Respect for the patient’s autonomy or own wishes requires that which of the following be assessed? a. b. c. d. e.
The needs of society The duty not to inflict harm The impact that the treatment will have on the patient’s quality of life Consideration of what is the best treatment The patient’s personal values