Medical Ethics, Patient Autonomy, and Informed Consent in Anaesthesia — WACS Viva & Clinical Scenarios (Health Management, Medical Ethics and Professionalism)
Exam-style medical ethics, patient autonomy, and informed consent in anaesthesia viva scenarios with examiner probes and model answers for ANAESTHESIA…
Scenarios covered
- SCENARIO 1: OSCE / Viva Voce Station: A 42-year-old known Jehovah's Witness is scheduled for an urgent laparotomy for a bleeding ruptured ectopic pregnancy or perforated intra-abdominal viscus. The patient remains conscious and explicitly refuses whole blood and primary blood components. Detail your approach to pre-anaesthetic informed consent, ethical navigation, and perioperative management.
- SCENARIO 2: Clinical Scenario / Viva Voce: An 82-year-old patient with end-stage metastatic colorectal cancer and a formal Do Not Attempt Resuscitation (DNAR) order presents for an emergency palliative colostomy due to complete bowel obstruction. Discuss the perioperative renegotiation of the DNAR directive with the surgical team, patient, and family.
- SCENARIO 3: OSCE Communication Station: A 15-year-old patient presenting with a severely displaced fracture requiring open reduction and internal fixation expresses an understanding of the procedure and anaesthetic risks, but their parents refuse consent for general anaesthesia based on non-medical beliefs. How do you assess capacity, evaluate legal competence, and resolve this ethical conflict?
- SCENARIO 4: Viva Voce Prompt: Outline the ethical framework and clinical criteria required for the determination of death by neurological criteria (brain death) and the ethical stewardship involved in somatic maintenance for solid organ donation in an intensive care unit.
- SCENARIO 5: Structured Essay / Short Answer Question: In emergency anaesthetic practice, explain the legal and ethical doctrine of implied consent in unconscious trauma victims without available surrogates, and contrast this with the management of a previously documented advance healthcare directive.