ethics

Question 1

withholding vs withdrawing

Answer 1

no ethical difference

Question 2

when can minors have a say in their treatment

Answer 2

if emancipated or if “mature” (~14)

Question 3

beneficial interventions

Answer 3

temporary revisions to standing DNR orders (e.g. in case of surgery)

Question 4

PCP’s role with insurance companies

Answer 4

advocate for patient for crucial services

e.g. advocate for referrals, medications, etc even if negatively impacts PCP

Question 5

dead donor rule

Answer 5

removal of paired/vital organs and a non paired organ cannot precede or cause death

Question 6

savior sibling rules for SCT

Answer 6

• no adult or donor options are available
• strong positive relationship between siblings
• both donor and recipient benefit
• risk to donor is minimal
• child must assent if old enough

Question 7

savior sibling rules for solid organs

Answer 7

• donor and recipient have to benefit
• surgical risk to donor must be minimal
• absence of coercion verified by 3rd party

Question 8

assent of child

Answer 8

• input solicited
• age-appropriate understanding of situation
• tell child if treatment will happen regardless of child’s assent
• respect if culture says not to involve child

Question 9

inclusion of test on NBS

Answer 9

• significant deleterious effect
• effective treatment if diagnosed early
• screen that is acceptable to the population

Question 10

GH is FDA approved for

Answer 10

• Turner syndrome
• chronic renal insufficiency
• Prader Willi
• idiopathic short stature

Question 11

HIV positive child

Answer 11

• support for teens
• no boxing, wrestling
• NOT mandatory to disclose to school
• identify health proxy for teens

Question 12

IPV exposure for chidlren

Answer 12

• at risk for physical injury
• increased chance of aggression
• separation anxiety
• at risk for school failure and risky sexual behavior

Question 13

reporting IPV

Answer 13

mandatory reporting bc child may be exposued

Question 14

foster care

Answer 14

• health screen within 72 hrs
• comprehensive assessment within 30 days
• child represented in court by law guardian (trained volunteer or attorney)

Question 15

children in research

Answer 15

• healthy: cannot participate if more than minimal risk
• w/disorder: can participate if there is potential benefit (if no direct benefit, only if minor increase over minimal risk)

Question 16

malpractice

Answer 16

deviation from standard practice causing breach of duty to act reasonably and resulting in injury to patient

• situations with potential for litigation should be reported to malpractice carrier ASAP
• disclosing errors to families legally and ethically mandated