420 Obstetrics and Gynecology Board Review •••
❍ A fully coherent, adult Jehovah’s Witness is having a massive lower GI hemorrhage and is refusing
transfusions. Is the physician legally bound to administer blood products due to the imminence of death if a
transfusion is not performed?
No. The principle of autonomy dictates that this patient may refuse blood products even if it results in his/her death.
❍ True or False: A patient with stage I bronchogenic carcinoma has pulmonary edema requiring mechanical
ventilation. You explain this to the patient and he agrees with proceeding with intubation and mechanical
ventilation. His wife refuses. The physician should not intubate the patient.
False. The principle of autonomy declares that each individual is the ultimate arbiter of his or her own health care.
❍ When can confidentiality be broken?
Confidentiality can be broken at the patient’s request, in the case of abuse (child or elder), court mandate, reportable
diseases (HIV, gonorrhea, chlamydia, etc), and in instances of a patient being a danger to themselves or others.
❍ Is it ethical to release information to insurance companies?
Yes. However, this information should be limited to processing an insurance claim.
❍ May a physician disclose the content of a medical record to another health-care professional in the regular
course of treatment?
Yes. As long as the other physician is participating in the care of the patient.
❍ May a physician disclose the content of a medical record under a court order?
Yes.
❍ May a physician disclose the content of a child’s medical record to school officials who request it?
No.
❍ In what circumstances do minors not need consent from a parent/guardian?
(1) When receiving care for sexually transmitted diseases (STDs).
(2) When receiving treatment/care for pregnancy (NOT including abortion).
(3) When receiving treatment related to drugs and alcohol.
(4) When prescribing OCPs or receiving condoms in a clinic setting (rules are different in other settings).
❍ True or False: Testing may be performed on a patient at the request of the patient’s partner, family members,
employers, or health insurers without the consent of the patient.
False. Testing may only be performed when the patient understands the risks and benefits of a test and has given
their consent
❍ When is partner consent needed for a woman to participate in a clinical research trial?
(1) The partner is a subject of the trial himself.
(2) The partner will be exposed to an investigational agent, which has a potential for greater than minimal risks.
(3) The partner’s acceptance of the treatment, or the impact of his acceptance on the woman, will be collected as data.
(4) If characteristics of the partner are listed as inclusion or exclusion criteria.