535
child,639591011053113146180240270
doctors939591011067127180213273313360
decided1329591011067120173206266319379
to1738591011040100
call1870591011060113146179
the2079591011041101154
child's2263591011060120153187247269314
parent2607591011067120161214273307
first294459101104780120168201
and3175591011061120180
wait3392591011087140173206
for3629591011047107147
them3805591011040100154247
to4082591011040100
come4212591011061121214267
and4509591011060120180
sign471959101105487147206
the4955591011041101154
medical5146591011093146206240293347381
record.63972901104093146205245305335
Analyze639867011073133193227280326380
the104886701103494147
actions1225867011060113146179239299346
of160186701106094
doctors1725867011060120173206266313359
from211586701103380135222
the236786701103393147
point2543867011060120153213247
of282086701106093
view294386701105487140220
of319386701106094
medical3317867011086139199232286346379
ethics372686701105386146180233279
and4035867011060120180
legal424586701103588148208242
norms.4517867011060120166253300330
Case7.6391143011080140187240300330
Patient6391281011067120153187240300333
M.,100212810110132162192
17,12241281011085145175
suffers14291281011072132172209263302348
from18071281011065105164258
severe20951281011072125185238278332
gastroesophageal24561281011085138185218258318371417477537597652711765817850
reflux33361281011067121161194254314
disease.36811281011085119165219272318371401
He411212810110112165
constantly43071281011079138198245278332391425458520
complains48541281011078138231291325378411471518
of54021281011085126
heartburn6391419011060113166206239299359399458
and11271419011067126186
belching,13431419011073127160213273306366427456
and18291419011068127187
can20461419011066119179
only22551419011073133166228
sleep2510141901106093147200259
in27991419011047107
a29361419011066
sitting3032141901106194127161195255315
position.33761419011073133180213247280340400430
Surgery38361419011079139179236289328390
is4254141901104794
indicated.43781419011047107167200254306339393453483
The48911419011085145198
patient's51181419011073127159193246306339362409
mother6391557011093153187247300340
against10091557011053113165198258305338
the1378155701103393146
operation15541557011060120174213267300335395455
(she2039155701104086146199
is2268155701103380
afraid2378155701105393133187220280
of26881557011060100
complications),28181557011053112206267300334387440473506567627673713743
she35911557011047107160
writes37811557011086126159192246292
a41031557011054
refusal.4186155701104195135195241295327357
Questions6391695011087147200246279313373433480
for11491695011040100140
discussion:1318169501106093140193253300347380440500534
1)8191833011060100
What99918330110113174227260
rights1289183301104073133192226272
does15911833011060120174220
this1841183301103393127174
patient20451833011060113146180233293326
have?24011833011060113173227279
2)8191971011060100
How9991971011087147233
should12621971011046106166226260320
a16121971011053
doctor16951971011060120173206266306
act20311971011053107140
in2201197101103595
this2326197101103393127173
situation2529197101104781114174228261294354414
(ethical2973197101104094126186219273326359
and33621971011053113173
legal3565197101103387146200232
norms)?38271971011060120160254300340394
Case8.6392247011080140187240300330
A6392387011087
woman75623870110116176269323382
with116823870110117150183243
bleeding14412387011090124177230290323383443
was191323870110117170216
admitted21592387011083143236269303336390450
to26392387011063123
the27922387011063123177
gynecology29992387011089150208261315375408468529590
department.36162387011090144203257296330423476536569599
Her424723870110116169209
HIV448623870110116157242
test47582387011063116163196
result49842387011070123169229262296
was531023870110117170216
positive.6392547011060120167200234267327381410
The10792547011073133187
woman12952547011087147240293353
asked1678254701105399159214273
that1981254701103494147180
this2191254701103494127174
information2395254701103494134194233326380413446506566
not29912547011060120154
be31752547011060113
disclosed3319254701106093140193227287333387447
to3796254701103393
her39192547011060113153
husband.41022547011060120166227281340400430
What63927050110100158218252
are9212705011060106160
doctors11102705011060120175208268314361
obliged15012705011060120154187248301360
to1891270501103494
do,20152705011060120150
taking2195270501103393147180240300
into2525270501103393127187
account27422705011060113166225285345379
legal3151270501103387146206240
and34212705011060120180
ethical3631270501105386146180233293326
norms?39872705011060120167254300360
Case9.6393000011080140187240300330
A6393138011087
young7483138011091149209269330
man110731380110123176236
living1373313801106397157190250310
with171231380110117150185245
HIV198731380110116157241
enrolls22563138011083142183243277310357
in26433138011063123
a27963138011084
university.29093138011090150182242295335381415448510529
He346831380110117171
visits36683138011090123170203237284
the39823138011064124177
university's41893138011089148182242295335381414448509529575
student47943138011077110170230284344377
clinic,52013138011083116149210243296326
intending639327601103393127180240300333393453
to1121327601103797
receive1248327601104497150202235295348
routine16263276011044104164197230292345
outpatient20003276011064124157217271304337391451484
care,25143276011057109149202231
and27753276011059118178
discloses2983327601106497144197230290337390437
his3450327601106397143
HIV36273276011087128211
status.3866327601105083137170230277307
At42053276011087121
the4356327601103797150
clinic,4536327601105790123183217270300
he48663276011063117
is5012327601103784
told5125327601103797130190
that5344327601103797150184
he6393414011060113
must7893414011093153200233
receive10533414011047100153205238298351
care14343414011061114154207
at1670341401106194
a17943414011060
specialized18853414011054114167220253306339373426480540
center,24553414011060113172206259299323
as28083414011061107
they29453414011041101155216
have31883414011067122181235
the34523414011041101154
necessary36363414011067120173227273320373413474
specialists,41383414011054114168221254307341374421454501531
medications,47063414011094147207240294346379413473533580610
and53463414011060120180
other639355201106093153207247
resources,915355201104093139199259299353406452482
and14273552011053114174
that1631355201103494147180
the1841355201103494147
student2018355201104680140200253313346
clinic2394355201105387120180213267
is2691355201103380
not28013552011060120153
authorized29843552011054114147207267307340393447507
to3521355201103393
admit36443552011053113207240274
him.3948355201106093187217
To6393690011067116
what78536900110101161221254
extent10683690011074127160213273306
is14043690011054101
it1535369001105487
justified16523690011053113160193226259293346406
(from2088369001106092139194281
an23993690011080140
ethical25693690011074107167200254313346
and29453690011081141201
legal31763690011054107167227260
standpoint)34663690011067101161221281341401434494528568
for40623690011054114161
a42523690011080
student43623690011067100160220274334367
clinic47593690011074107140200234287
to50763690011053113
refuse52183690011067116149209256309
medical6393828011087140199233286346379
care10483828011053113160209
to1287382801103393
an14103828011060120
HIV-infected15603828011087127200241274334368421474507560620
student?2210382801104780140200253313347407
Case6394104011080140187240
10.9094104011060120150
The6394242011073133187
patient,8554242011092146178212265325358388
29,12734242011093153183
is14874242011066112
eight16294242011086119180240274
months193342420110126186246279339386
pregnant.23494242011092132186246305358417451481
She28604242011099159214
is31034242011066113
unmarried.32464242011092152246299339379413466525555
This383142420110106166199246
is41074242011066113
her42514242011092146185
first44664242011073106146193226
pregnancy.47224242011093133187247306359419472534554
The530642420110106167220
pregnancy6394380011060100153213272326385438500
is1167438001103783
progressing12804380011064105165226265318364410444504565
normally,18754380011065125165258312344378439460
and23654380011056116176
all2571438001105891124
necessary27264380011063116169223269316369409471
tests3224438001103791137171217
have34714380011064117177230
been37324380011063116169229
completed.39914380011058117211271305359392445505535
The45594380011074133187
fetus4775438001104498130190237
is5042438001103784
in5156438001103797
good52834380011064123183244
health.6394518011060113166199232293323
As99245180110108154
for11764518011063123164
the13704518011055115169
pregnant15694518011082122175236294349408442
woman204145180110109169263316375
herself,24464518011083136176222276308348378
she28544518011070130183
cannot30664518011078130190250310343
be34394518011083137
considered36054518011076136196242276336389429483542
completely41774518011076136230290323377410463497558
healthy.47624518011083136190223256317378398
She51904518011090150203
is54234518011056102
receiving639465601104093146198231291325385446
treatment1114465601103676129182214308361421454
from1598465601104383142235
a18654656011055
cardiologist19504656011055108148208241301334394454487533567
due25474656011062122176
to2752465601103696
cardiovascular28784656011056108148208241301361415461514574607660700
issues.3608465601103582129189242288318
She39594656011067127180
also4169465601105588135195
has43944656011062116162
a45864656011056
history4671465601106699146178238278339
of50394656011060101
allergic5170465601105588121175214273306359
reactions639479401104093146198231265325385432
to1101479401103393
several12244794011047100160213254307340
medications.15944794011093147206239294347380413473533580610
For6394932011067126166
a8354932011056
number9214932011063123217277330370
of13204932011064104
reasons,1454493201104397150196256316363393
the1878493201103797150
patient20584932011063117149183236296329
asks24174932011057103163210
the2657493201103797151
obstetrician/gynecologist2838493201106312316920325528832836141544850156159465571777482788094097310331094112711731207
to4075493201103797
perform42024932011064117156196256296389
a46214932011057
cesarean47074932011057111157210250304357416
section.51534932011050104157189223283344374
Specifically,6395070011067127180233266306339393446478512573594
the12635070011040100153
patient14465070011067121153187240300333
is1809507001104189
anxious.19285070011061120180214274334381411
She23695070011073133187
is2585507001104187
very27025070011068121161221
afraid29515070011060100140194226286
of32675070011068108
the34055070011040100153
pain35885070011067120153213
associated38315070011060107153213267300353386441501
with43695070011087120154214
childbirth46135070011060120153187247307340380414474
and51175070011060120180
also5331507001106093140200
believes6395208011060113146180233293346392
that10615208011044104158191
a12825208011064
cesarean13755208011064117163217256310363423
section18285208011058111164197231291351
will22205208011086120153186
help24375208011070124157217
her26845208011070124163
maintain28885208011093146180238272325358418
her33365208011071124164
figure3530520801105083143202242296
better.38565208011070124156190243283305
Furthermore,41915208011079139179213273326365459519559611641
someone48625208011057117211264324384437
told53295208011044104137199
her6395346011060113153
that822534601103393146179
a10315346011053
cesarean11145346011054107154207246300353413
section15575346011046101154187220280340
would19275346011087147207240300
also2257534601105486133193
be24805346011060113
better26235346011060114146180233273
for2926534601104099140
the3096534601103494147
health32725346011060114166199233293
of35955346011060100
the3725534601103393147
newborn.39015346011060114200260320361421451
The6395484011073133187
woman8615484011087147240293353
insists1244548401103999146179226259306
on15815484011065125
her17365484011066120158
rights,1924548401104579139197231277307
reminding22615484011047100192226286346379439499
them2790548401103999152245
that30655484011041101154187
she32825484011053113166
has34785484011066119165
the36735484011040100153
right3856548401104679139198234
to4120548401103999
choose42495484011058118178238284338
the46165484011040100153
intervention.4799548401103999132186225285339398431464525585615
If5444548401104684
the639562201103393147
doctor8165622011060120173206266306
refuses1152562201103992133193240293339
the1521562201103393146
operation,16975622011060120175214267300333394454484
she22115622011046106160
is2400562201103480
prepared25105622011060100154213267307360419
to2959562201103495
file3084562201104073107160
a32745622011053
lawsuit.3356562201103487174220280313347377
The6395760011073133187
gynecologist8555760011061122180234287346380440501533580613
sees14995760011048101154200
no17295760011061121
reason1880576001104194147193253313
to2223576001103595
perform23485760011061114154194253293386
a27645760011055
cesarean28485760011054107153208248302354414
section.32925760011047101154187220280340370
He36935760011087140
is3863576001103481
particularly39745760011061114154187221274335368421461494555
concerned45575760011054114174228281320380434494
about50815760011054114174234267
the5378576001103595148
woman's6395898011087147240293353374420
health10895898011063118171204237297
due14165898011064124177
to1623589801103696
her17495898011064117157
underlying19365898011063123183236276309371402462524
medical24925898011093146206240293346379
conditions.29015898011058117179239272305339401461508538
He34735898011086139
believes36425898011063117149183236296349395
the4067589801103797151
surgical42485898011050110149207239292346379
risk4657589801104477124184
in4871589801103797
this4998589801103797130177
case52055898011057110156210
is5445589801103784
significant,639603701104780140199233273306359412472505535
and12046037011055114174
a14086037011053
natural14916037011060113146206246300333
birth1854603701106195135168228
with21126037011087120153214
the2356603701103393146
necessary25326037011060114166219265312365406468
support30276037011047107167227287327360
would34176037011087147207240300
be37476037011060114
preferable.38906037011060100154194247286340400434487517
However,6396175011087147233286346399439464
the11336175011048108161
gynecologist13246175011074135193246300360393453514548594628
would198261750110101161221254314
be23266175011075128
extremely24846175011067125160200253346399432494
reluctant30046175011055109142202256289342402435
to34696175011048108
end36076175011068127187
up38246175011075135
in39896175011047107
court.41266175011068128186226260290
Besides44466175011094146192226286339386
the48626175011047107161
hardships50536175011074127167227273333367428474
associated639631301105399146206259293346379432492
with11696313011087120154214
the14136313011042102155
trial1598631301104181115168201
itself,1829631301104377124177211250280
the21396313011042102155
doctor23246313011068128181214274314
is2668631301104289
also2787631301106194141201
concerned30186313011063123183236289328388442502
that35506313011041101155188
he37686313011068122
believes39196313011068123156189243302357403
the43526313011041101155
lawsuit4537631301104194181227287321354
will49306313011086120153186
damage51476313011068121214268328380
his639645101106093140
reputation809645101104093153213246299333366426486
among13256451011053147207267327
colleagues16816451011054113147180234287347406459506
and22176451011053112172
patients.24196451011060115148181235294328374404
Questions6396589011087147200246279313373433480
for11496589011040100140
discussion:1318658901106093140193253300347380440500534
1)8196727011060100
Should9996727011067127187247280340
a13696727011066
doctor14646727011072132186218278318
act18126727011067119152
in19946727011046106
accordance21306727011066120173233273333386445499552
with27256727011086120153213
the29686727011045105159
patient's31576727011071126159192246306340361407
wishes?36066727011087120167227280326379
How40176727011099159246
can42926727011065119179
a45016727011065
doctor45966727011073133187220280320
justify49466727011045105151185219259319
their52936727011047107160193233
position9996865011060120167200234267327387
from1416686501104080140233
a16796865011053
legal1762686501103487147200233
perspective?20256865011060113153199261314367400433493547599
2)8197003011060100
Determine9997003011087140173226266359392452506
what15447003011086146199232
the18067003011043103156
doctor's19927003011070130183216277317339384
tactics2406700301104396150183216270316
might27627003011093127187246279
be30717003011070123
in32247003011043103
this33577003011043103136183
situation3570700301105690123183237270303363423
in40237003011042102
accordance41557003011063116169228268328381441495548
with47427003011086120153213
ethical4985700301106396156189243296329
and53447003011063122182
legal999714101103387147200233
standards.1262714101104680133193253306346406452482
3)8197279011060100
Could9997279011080140200234294
a13237279011053
conflict14067279011053112172212246279332365
arise1801727901105494126173226
between20577279011060115148234287340400
ethical2487727901105386146179233287320
requirements2837727901104093152212246286340433486546579627
and34947279011053113173
legal3697727901103387147200233
norms39607279011060120160253300
in4290727901103393
this4413727901103494127174
situation?4617727901104780114174227261294354414466
Case6397554011080140187240
11.9097554011060111141