WBR0760

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Ethics
Sub Category	SubCategory::Head and Neck
Prompt	[[Prompt::A sick-looking 7-year-old girl is brought to the emergency department (ED) in respiratory distress. The physician quickly inquires about her condition. Her mother informs the physician that the entire family lived in India and only recently emigrated to USA. The girl has not received any childhood vaccinations. On physical examination, the girl is in acute distress; she is sitting in a tripod position. Her breathing is laborious, and she is drooling. The diagnosis of acute epiglottitis is promptly made, but the girl suddenly turns blue and collapses. The physician rapidly perform an urgent tracheostomy. The mother intervenes, saying that the family's religious beliefs prevent the girl from having any surgical procedure. What must the physician do in this case?]]
Answer A	AnswerA::Respect of the family's belief and stop the urgent tracheostomy
Answer A Explanation	AnswerAExp::In life-or-death emergency situations, a minor's urgent care must not be withheld under any circumstance.
Answer B	AnswerB::Perform the urgent tracheostomy despite the family's decision
Answer B Explanation	AnswerBExp::Since urgent tracheostomy is the a mandatory life-saving procedure for this minor, the procedure should not be withheld. regardless of the family's beliefs.
Answer C	AnswerC::Call the patient's father to make sure he approves of the mother's decision
Answer C Explanation	AnswerCExp::The physician must not waste time calling other family members while the patient is at risk of death.
Answer D	AnswerD::Call the ambulance to transfer the patient to another medical center
Answer D Explanation	AnswerDExp::Physicians must not escape urgent cases at hand. Also, the patient might die while calling the ambulance and waiting for its arrival.
Answer E	AnswerE::Get a second physician opinion on the matter
Answer E Explanation	AnswerEExp::A second opinion is not necessary in the urgent care of minors.
Right Answer	RightAnswer::B
Explanation	[[Explanation::A minor is any individual of less than 18 years of age. Generally, a minor's parents have the right to refuse medical care for their child. But in the case of an emergency involving a minor, patient care must not be compromised despite family refusal. In emergency life-or-death situations, the physician must perform whatever it takes to save the minor's life regardless of the parent's decisions. The physician must not waste time calling for help or inquiring about legal issues in such emergency situations. On the contrary, physicians are protected by law to provide urgent care for minors. Educational Objective: In life-or-death situations, a minor's emergency care must not be withheld under any circumstance. References: ]]
Approved	Approved::Yes
Keyword	WBRKeyword::Tracheostomy, WBRKeyword::Minor, WBRKeyword::Religion, WBRKeyword::Religious belief, WBRKeyword::Epiglottitis, WBRKeyword::Ethics
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::