WBR0281

Author	[[PageAuthor::Ayokunle Olubaniyi, M.B,B.S [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Ethics
Sub Category	SubCategory::General Principles
Prompt	[[Prompt::A 67-year-old post-menopausal Japanese woman (Gravida 2, Para 2) presents to the ER with a 4-month history of a gradually progressing abdominal distension, fatigue and a 5kg weight loss. She had a medical history of vaginal hysterectomy because of a uterine prolapse after menopause at the age of 58. On examination she appears malnourished, pale, pupils are round and reactive with scleral icterus. Lungs are clear. Cardiac examination demonstrates a normal S1 and S2 with a 2/6 systolic murmur at the left sternal border. Abdomen is distended with a positive fluid thrill. Laboratory studies shows her level of serum cancer-related antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were 170.0U/mL (normal range is 0 to 35U/mL) and 15.1U/mL (normal range is 0 to 37U/mL) respectively. She was diagnosed of stage IV ovarian cancer following initial staging and a debulking operation. She refused chemotherapy and the physician agrees to follow her wishes. This is an example of which ethical principle?]]
Answer A	AnswerA::Authority
Answer A Explanation	AnswerAExp::Authority – By definition, this means the right or means to command or control others. This is not an ethical principle in medical practice.
Answer B	AnswerB::Autonomy
Answer B Explanation	[[AnswerBExp::This principle means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. These decisions must be respected by everyone, even if those decisions are not in the best interest of the patient.]]
Answer C	AnswerC::Beneficence
Answer C Explanation	AnswerCExp::All healthcare professionals must strive to improve their patient’s health, to do the most good for the patient in every situation. Ultimately, the patient has to make an informed decision.
Answer D	AnswerD::Justice
Answer D Explanation	AnswerDExp::This principle demands that all healthcare providers should try to be as fair as possible when offering treatments to patients. You should be able to justify your actions in every situation.
Answer E	AnswerE::Nonmaleficence
Answer E Explanation	[[AnswerEExp::This means “do no harm.” This means that healthcare professionals have a duty to protect patients from harm. However, when the benefit of a treatment outweighs the risk, the patient has to make an informed decision in order to proceed with the treatment.]]
Right Answer	RightAnswer::B
Explanation	[[Explanation::Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. There are four basic principles which form the bedrock of the medical profession: autonomy, beneficence, justice, and nonmaleficence. Educational Objective: Physicians must respect patient's rights to autonomy. References: First Aid 2014 page 59]]
Approved	Approved::Yes
Keyword	WBRKeyword::Principles of medical ethics, WBRKeyword::Autonomy, WBRKeyword::Nonmaleficence, WBRKeyword::Beneficence, WBRKeyword::Justice, WBRKeyword::Ethics
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