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7_" A drive in school came to a clinic and suffered of epilepsy and wanted the doctor to give him a report that he's medically free and doctor accepted"
A) What are ethical problems related to this case and how to solve it
yourself?
B) What are responsibilities of the physician towards society and humanity

Answers
———

Ethical Problems:

1. Falsification of Medical Records:
• Providing a false report that the patient is medically free from epilepsy is unethical and illegal. It compromises the integrity of the medical profession and can have serious consequences for the patient and others.
2. avoid harm to others:
• Allowing an individual with uncontrolled epilepsy to drive poses a significant risk to public safety. Seizures while driving can lead to accidents, potentially causing harm or death to the driver, passengers, and others on the road.
3. Patient’s Best Interest:
• Issuing a false report does not serve the patient’s best interest. It may prevent the patient from receiving necessary medical treatment and guidance to manage their condition effectively.

To solve those issues

Honest Communication:
- The doctor should explain to the patient the importance of an accurate medical report and the potential risks associated with driving if their epilepsy is not well-controlled.

2. Proper Assessment:
- Conduct a thorough medical evaluation to determine the patient's current condition and whether they are fit to drive. This includes considering the frequency and severity of seizures, medication adherence, and any recent changes in their health status.

3. Referral to a Specialist:
- If necessary, refer the patient to a neurologist or an epilepsy specialist for further evaluation and management.

4. Legal and Ethical Adherence:
- Follow the legal and ethical guidelines set by medical boards and regulatory bodies regarding reporting and fitness to drive for individuals with epilepsy.

B- Responsibilities towards society and humanity
1- Have an obligation of preserving human life
2- Recognize & deal with unethical behavior of colleagues & health care team. 3- Certify only that which he has verified
4- Provide health care based on wise_& appropriate allocations of limited medical resources (avoid prescribing unnecessary medication, investigation, procedure)
5- Obligation of public reporting of significant, medical hazards (epidemic infection)
6- Oblitogtheahetalthiofosonciety. Participate in all efforts to provide, improve & maintain health care quality for society as a whole.

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8- Name examples of malpractice

Answer
———

Dereliction or negligence (deviation from standard care)
Duty: established physician-patient relation-ship that causes: Damage, injury
- Directly to the patient (by negligence, not another factor)

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أبشروا!

II- Communication

1-A 45-year-old female suffering from severe colic, came to the outpatient clinic
surrounded by 5 of her family members. They were upset and worried about her and were
shouting loudly in the clinic. The attending doctor asked most of the family members to get
out of the room, leaving only one person to stay with the patient. This provoked the family
members' anger especially when the physician was using some English medical words, which
they could not understand.

a. What is your point of view concerning the physician's decision? (2 marks)
b. What are the factors that lead to a successful medical interview? (4marks)
c. How to improve your way of giving information during medical interview? (4 marks)

Answers
———
a) I think the physician decision of letting only one family member be with the patient is
right to maintain discipline in the clinic. But his communication with them was poor
as he used English words while speaking which may affected their understanding of
the situation or they might feel that the doctor was arrogant.

b)
1. Patient related factors:
- Patient's belief of health and illness
- Problem wished to discuss
- Previous experience with medical care
- Current experience with medical care
- Expectations of the doctor will do
- How the patient perceives the role of the doctor
2. Doctor related factors:
- Personality
- Physical factors
- Psychological factors
- Problem wanted to be discussed with patient
- Communication skills
- Self-confidence in the ability to communicate

c)
1. Discuss& clarify every given information.
2. Begin the interview by summarizing the patient's condition.
3. Assess the patient's understanding of the condition.
4. Outline plan of the rest of the interview.
5. Discuss& explain every part of information in appropriate language
6. Mention the most important first

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2- A 35- year- old single lady came to the clinic with continuous vaginal bleeding for
one month. She was terrified from having cancer uterus as she was not yet married. She went
to the gynecologist who suggested a hysterectomy as soon as possible. When she started to
negotiate for other alternatives of management, the doctor replied that he is the specialist
and he is choosing the best for her and otherwise she might lose her life.

a) Based on medical psychology principles; what type of doctor- patient relationship is adopted by
this gynecologist? (2marks)
b) What is your opinion concerning this type of doctor patient relationship? Is there any kind you
prefer in communicating with the patient? (4marks)
c) How would you deliver bad news to the patient? (4marks)

Answers
———

a) This gynecologist adapted the active-passive relationship, in which the patient's role
is completely passive. In this model the doctor wants to lead all the treatment process
without taking into consideration the patient's rights to choose her treatment plan and
to decide what's best for her.

b) I think this model isn't appropriate in this situation as the patient is able to make her
own decision and she has the right to participate in choosing the treatment plan that's
best fits her life style. I also think that doctors shouldn't ignore the patient's opinion
and willingness.
The best doctor-patient relation ship is the rapport model, in which patient and doctor
are cooperative to approach the best for the patient. This model is based on
acceptance, care, empathy, understanding the patient's feelings and problems within a
professional context.

c) Bad news is a relative concept that depends on the patient's interpretation of the
information given and their reaction to it, therefore what's considered bad news for
someone might not be bad news for others. It depends on the patient's personality,
situation and emotions. That's why doctors should consider the individual patient's
needs and circumstances. Doctor needs to be open, honest and provide reassurance
and emotional support to his patients.