02-19-2018, 09:54 AM
17 year old primigravid at 41 weeks' gestation comes to the physician for routine checkup. Father of the patient's baby is in the room. Pregnancy has been uncomplicated. Exam shows uterus at 41 weeks. Physician recommends twice weekly NSTs and an IOL at 42 weeks to reduce risk of infant mortality and morbidity. Patient refuses recommendations after discussing risks, indications, and benefits. What is the most appropriate response?
A. Ask the father is he agrees with patient's decision
B. Obtain informed consent from patient's parents for IOL at 42 weeks
C. Obtain Psychiatric evaluation of patient's decision making ability
D. Respect patient's wishes and follow up in 1 week
E. Transfer the patient to a physician who is comfortable with her decision
I understand that the patient has autonomy over her care as well as her baby's and can deny treatment options, but am still uncertain about what the correct answer is. D or E are my first thoughts, but if anyone can confirm, shed some light, I would appreciate it! Thanks in advance.
A. Ask the father is he agrees with patient's decision
B. Obtain informed consent from patient's parents for IOL at 42 weeks
C. Obtain Psychiatric evaluation of patient's decision making ability
D. Respect patient's wishes and follow up in 1 week
E. Transfer the patient to a physician who is comfortable with her decision
I understand that the patient has autonomy over her care as well as her baby's and can deny treatment options, but am still uncertain about what the correct answer is. D or E are my first thoughts, but if anyone can confirm, shed some light, I would appreciate it! Thanks in advance.