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Retired NBME 24 Answers

nbme24/Block 2/Question#8 (reveal difficulty score)
A 17-year-old girl is brought to the hospital ...
Beneficence ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +7  upvote downvote
submitted by โˆ—famylife(110)
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"Beneficence involves balancing the benefits of treatment against the risks and costs involved, whereas non-maleficence means avoiding the causation of harm."

https://www.alzheimer-europe.org/Ethics/Definitions-and-approaches/The-four-common-bioethical-principles/Beneficence-and-non-maleficence

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 +1  upvote downvote
submitted by proteinbound123(3)
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Beneficence: health care providers have a duty to be of a benefit to the patient and should take positive steps to prevent and to remove harm from the patient.

Consent for minors (FA2020 pg 265): Consent should be obtained from parents, except for Emergency Medicine.

This is a case where the Principle of Beneficence is given priority over the principle of respect for the patient's autonomy. In Emergency Medicine, the patient is incapacitated by the grave nature of accident or illness, we presume that the reasonable person (in this case, the patient's parents) would want to be treated aggressively, and we rush to provide beneficent intervention by stemming the bleeding, mending the broken or suturing the wounded.

So by the Principle of Beneficence, the surgery was indicated and by the same principle, the doctor proceeded without permission because it was a case of Emergency Medicine.

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misterdoctor69  What I found strange about the question was that the parents were even contacted for consent to begin with..when, as you clearly stated, consent isn't needed for emergency medicine. In the hypothetical scenario where the parents were able to be reached and they said, "No, don't do the procedure," what would happen next? +2
yousif7000  I think you'll proceed anyway since the parents refusal is kinda considered as child abuse at this point +
helppls  I was a little confused, I assumed that proceeding with the surgery would prevent further complications (herniation). Thus preventing harm = nonmaleficence? +2



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