••• Chapter 42^ Ethics, Psychosocial, and Psychiatric Pearls^421
❍ True or False: When it comes to testing that may have certain medical and/or psychosocial ramifications for
a patient (ie, HIV testing and genetic testing) that may require comprehensive explanations and possible
counseling, a physician must be the person that portrays this information to the patient.
False. Physicians may need to refer some patients for comprehensive counseling if time constraints or lack of
specialized expertise make it difficult to offer appropriate counseling in a particular practice.
❍ Do patients need to be informed prior to testing if the results of the test must be reported (ie, HIV testing
and STDs)?
Yes. Patients must be told before being tested if their tests results must be reported.
❍ Are physicians obligated to perform every test a patient requests?
No. Physicians are not ethically obligated to perform every test a patient requests.
❍ Is there an ethical difference between withholding and withdrawing life-support measures?
No. Ethical principles underlying the decision apply equally in these two measures.
❍ What is the definition of medical futility?
(1) The patient has a lethal diagnosis or prognosis of imminent death.
(2) Evidence exists that the suggested therapy cannot achieve its physiologic goal.
(3) Evidence exists that the suggested therapy will not or cannot achieve the patent’s or family’s stated goals.
(4) Evidence exists that the suggested therapy will not or cannot extend the patient’s life span.
(5) Evidence exists that the suggested therapy will not or cannot enhance the patient’s quality of life.
❍ Does the concept of medical futility apply only to the cases of patients with terminal illnesses?
No. The concept of medical futility can apply to any clinical situation in which a proposed treatment offers
virtually no chance of achieving a desired result.
❍ In artificial insemination by donor, where the recipient of the insemination is married, who is considered
the legal father?
The husband of the woman receiving the insemination is considered the legal father.
❍ In order for surgical sterilization (tubal ligation) in a female to be performed, who needs to consent for the
procedure?
Although it is highly recommended that a woman consults with her significant other before the procedure is
performed due to the possible effects it may have on them, only the women undergoing the procedure needs to
consent prior to being performed.
❍ True or False: Consent is not required when sterilizing a woman/man with mental disabilities.
False. Consent is still required and can often require the assistance of an individual who is trained in
communicating with mentally disabled individuals. However, in situations where there is disagreement among
patient’s caregivers and consultants, court approval may be obtained.
*Imminent death, physiologic goal, life span, and quality of life do not have established definitions and are often a point of contention between patients
and physicians and even amongst medical professionals.