Authority of Parents and Consent of Minors: Children are considered incompetent under the law. The medical care of infants and children is authorized by surrogates, namely the parents of the child or other parties authorized by law. It may become necessary to determine the relevance and weight of parental preferences when these preferences conflict with the recommendations of providers. What would you do if a parent’s beliefs or preferences are counter to current recommended medical practice?
Contraception: Numerous young persons are sexually active in our society, and many do not share Christian beliefs regarding chastity. Assuming there is no gynecological requirement to regulate menstruation (if female), how would you counsel/respond to a young woman or man (less than 18 years old) who requested contraception at a health visit?
Drug Seeking Behavior: Unfortunately, drug-seeking behavior is increasing in our society for a variety of reasons such as personal drug abuse, adolescent experimentation, economic reasons (elderly selling pain medications to help pay bills, etc.), or failure of a managing provider to properly down titrate drug use. Nearly all providers are eventually asked to provide medications to patients without proper medical need. How do you respond to such a request? What alternatives could you suggest?
Futile interventions: Autonomy does not entitle patients to insist on whatever care they want. Providers are not obligated to provide futile interventions that have no physiologic rationale or have already failed to produce a therapeutic outcome. How would you respond to a patient requesting such care from you? What alternatives could you suggest?
Medically Assisted Dying: Some patients may conclude that the quality of their life is so diminished that life is no longer worth living. This conclusion may be the result of unrelieved pain or suffering, because they consider the prospect of deterioration, or because they believe that their lives are a burden on others. Persons who come to this conclusion are often terminally ill and under the care of a physician. It may occur to them to ask their provider to help them die quickly and painlessly. How would you respond to such a request? What alternatives could you suggest?
