Упрощенная HTML-версия
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him to you said that he had been in a fight with another prisoner. You
have a good relationship with the prison staff and do not want to harm
it by making unsubstantiated accusations of mistreatment of prisoners.
What should you do?
End-of-life decision
An 80-year old woman is admitted to your hospital from a nurs-
ing home for treatment of pneumonia. She is frail and mildly dement-
ed. You treat pneumonia successfully but just before she is to be dis-
charged back to the nursing home, she suffers a stroke that leaves her
paralysed on her right side and unable to feed herself. A feeding tube
is inserted that apparently causes her discomfort and after she has
made several attempts to pull it out with her left arm, a restraint is
placed on the arm. She is otherwise unable to express her wishes. A
search for children or other relatives who could help make decisions
about her treatment is unsuccessful. After several days you conclude
that her condition is unlikely to improve and that the only ways to re-
lieve her suffering are to sedate her or to withdraw the feeding tube
and allow her to die. What should you do?
4. Which of the GMC guidelines below is breached in each of
these cases?
a.
A GP falls asleep regularly during consultations. His colleagues
do nothing.
b.
A doctor is aware that a patient has a history of violence against
woman. She informs a friend whose daughter has just become en-
gaged to this man.
c.
A doctor attempts to dissuade a patient from having an abortion
as this procedure is against his religious beliefs.
d.
A doctor refers a patient to a medical textbook for an explanation
of his pancreatic cancer.
e.
A doctor fails to complete the number of days of professional de-
velopment training advised annually.
f.
A doctor tells a seriously overweight patient who has ignored his
advice to diet that she deserves any ill effects that might result
from her obesity.