205 (NEU)
Day 1: Neuro Anatomy
           introduction in Physion
Day 2: Neuro Anatomy
            Sensory Physiology
Day 3: Head Anatomy
            Rest of sensory, motor part 1
Day 4: Head Anatomy
            Rest of motor
Day 5: Neck Anatomy
            Special senses 1
Day 6: Neck Anatomy + Cases
            Special senses 2
Day 7: Histology part 1 (neuro + 1st part of CNS)

Day 8: Rest of Histology

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Last Revision
Day 9
Day 10

PSY

Files

Med Map's
Part 1
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Dr Effat's
Department's book

Sources

1️⃣ Dr Nagi
PlayList in the order of Dr Effat's file
Playlist in the order of Department book
Task: 1st 4 Videoes
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2️⃣ MedMap
Ethics
Psychology 1

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Pathology

Files

Written Q For every chapter
Written Q Dr. Eman

Sources

Today's task: inflammation
DR. Eman
DR.Elnemr

I- Medical ethics

1- During Ramadan, we are faced in the Media by a lot of advertisements for fund
raising for the treatment of sick children. Many of these T.V. advertisements include those
sick children themselves.

a- What is the ethical dilemma behind this issue? (3marks)
b- How can you solve this dilemma through ethical means? (4marks)
c- How can you obtain consent from the children? (3marks)

Answers
———

a) The appearance of sick children in such advertisements creates a conflict between the
interest to do good for these children by encouraging people to help them vs the
commitment of confidentiality and respecting their privacy.
b) To solve this dilemma, we should ask ourselves 5 ques to know whether this action is
ethical or not:
- What benefits & what harms will this action produce?
- How does it advance the common good?
- Does it treat everyone the same?
- Does this action violate any of the moral rights of the affected parties?
- Is this action consistent with moral virtues?
The ethical action is the one that best fits with these 5 approaches.
c) Valid informed consent should meet these criteria:
- Patient should be fully informed about the condition.
- Patient must be competent to make the decision.
- Patient's decision should be voluntary.
Since these children are considered incompetent the decision should be made by substitute
decision maker as their parents or legal guardian.

———————————

2- A patient visits a doctor in a rural general practice clinic. The patient complains of
recurrent headaches. The doctor asks a few questions, and suspects a disorder. He cannot
find the appropriate medication in his available list so he prescribes a medication that
relieves spasmodic pain on a piece of paper and gives the prescription to the patient.

a) List the ethical principles that this doctor violated? (3marks)
b) Explain how were these principles violated? (3marks)
c) if you were in the doctor's place: How would you manage in a more ethical way for practice.
(4marks)

Answers
———

a) - non maleficence principle.
- Respect for autonomy.
- Beneficence principle.
- Professional competence principle.

b)
1. Violation of non- maleficence principle:
The doctor didn't respect the (not to harm) principle by giving the patient drug to
relive spasmodic pain while she has headache which may cause her a medical issue.
2. violation of patient's autonomy:
The doctor didn't respect his patient right in understanding the situation and making
her choice about the treatment she will take.
3. violation of beneficence principle:
The doctor hadn't made what's best for his patient. He just gave her the available drug
which may harm her or can't help with the symptoms.
4. violation of professional competence principle:
Doctor should recognize the limits of his professional competence then act according
to these limits. The doctor in this case recognized that he has limited options but he
acted as he did the best for the patient.

c) If I were the doctor, I would respect the patient's autonomy and explain the situation
to her in simple words so she can understand that the best treatment for her condition
wasn't available and made her choose whether she prefers to take the spasmodic pain
reliver or not. I would also recommend to refer her to another practical clinic or to
prescribe another drug that can be bought from a separate pharmacy other than the
clinic's one.

———————————

3- You are a psychiatrist, today in your clinic you examined a patient suffering from
severe depression, death wishes, hopelessness, and suicidal thoughts, and You guessed that
this patient might commit suicide.

a- What are the general rules for confidentiality? How can they be applied in such patient? (5
marks)
b- Give examples about violating ethical principles in medicine. (5 marks)

Answers
———

a) Confidentiality is to respect the patient's privacy and autonomy and to prevent the
harm that may result from information disclosure. It extends even after patient's
death. Confidentiality can be broken in certain conditions as:
1. Serious harm to others
2. Possible commitment of suicide
3. Abuse to victims who can't defend themselves ie. Kids.

In this case doctor must break confidentiality as the patient may commit suicide.

b)
– violation of boundaries: crossing the boundaries in the doctor- patient relationship
and having improper sexual or emotional relation with patients or personal financial
gain.
- Mistreatment of the patient: negligence or lack of knowledge and skills.
- Violation of confidentiality: disclose patient's personal information without
consent.
- Violation of the rules of ethical conduct with other members of the profession.
- Illegal activities: illegal abortion or illegal business.

———————————

4- A 26- years old was preparing for her wedding came to your clinic complaining
from a breast mass and was confirmed with the mammography. You advised her that you
should prepare for a surgical operation at once and that she should postpone her wedding
until she undergoes the surgery. 2 days later her fiancée came to your clinic asking about her
condition.

a- What are the ethical dilemmas that you are facing, and how would you solve them? (5 marks)

b- What are the points which you will discuss with her when you are taking the informed consent
from her? (5 marks)

Answers
———
The doctor is facing a conflict between the commitment of confidentiality and
respecting the patient's privacy vs obligation to do good to the patient who needs
immediate surgery.
To solve this dilemma, we should ask ourselves 5 ques to know whether this action is ethical
or not:
1- What benefit& what harm will this action produce?
2- How does it advance the common good?
3- Does it treat everyone the same?
4- Does this action violate any of the moral rights of the affected parties?
5- Is it consistent with the moral virtues?
The ethical action is the one that best fits with these ques.

b) To take a valid informed consent you should fully inform the patient about:
- Her diagnosis.
- The nature of the treatment.
- Possible alternatives for the intervention.
- The risks and benefits of each alternative.
- The prognosis of the intervention.
You should also make sure she is competent and able to make a decision and her decision is
totally voluntary not under any type of pressure.

———————————

5-A 50-years old male suffering from chest pain he needs to do cardiac catheterization
procedure.
a- What are the characteristics of a valid informed consent? (5 marks).
b-What are the exceptions to the requirements of informed consent? (5 marks)

Answers
———

a) A valid informed consent should fulfill the following criteria:
- The patient should be fully informed about:
1. The diagnosis
2. The nature of the treatment
3. The possible alternatives of the intervention
4. The risks and benefits of each alternative
5. Prognosis of intervention
- The patient should be competent to make the decision
- The patient's decision should be voluntary.

b) Exceptions are:
1. When the patient:
- Is unable to give consent (unconscious)
- Is suffering from acute life-threatening crisis
- Is in need for immediate intervention.
2. if the patient isn't competent to make a decision as in children or patient's cognitive
capacity is impaired.
3. Cases in which fully informing the patient can cause serious harm.

———————————

6- A newly married couple worried about the possibility of getting child with inherited
medical condition, especially with the family history loaded with this condition from the wife
side. The wife visited you alone and she asked you to deny this fact in front of her husband

to save her marriage.
a- What are the ethical dilemmas encountered in this situation? (5 marks)
b- How would you manage this condition? (5 marks)