Like another common stated, B,C,D,E are wrong right off the bat. A says DISCUSS treatment and referral. It's not the same as saying refer to etc. Even if referral threw you off, don't you think it's important to ask the patient why he's doing what he is and if he wants to change/ or know the long term effects rather than straight up saying "here, take some methadone. it'll help you quit". what would you want in this patients shoes? someone to help you through the situation step by step (most probabaly)
We are constantly taught 'never refer, never refer' !!! but then nbme throws ques like this one. I have no clue how to answer ethics anymore :(
submitted by macroorchidism(7)
The way I rationalized this one was like this: 1) He was already 'caught' so you can eliminate any answer choice that deals with the handling of the law, as that will be handled by the third party (C&E) 2) Choice D also can be eliminated because you never want to snitch to the parents, especially since he is a grown ass man (he is over 18 and his parents have nothing to do with him now Medically/HIPPA) 3)Choice B is basically referring him to another doctor and comes off as passive aggressive (Pretty sure trust issues doesn't stop your obligation to help patients when concerning NBME) 4)Now you're left with A or F. F is almost like jumping to a treatment option without any 'consent' or discussion to see what's really going on with the patient...so no. 5) Above all else when dealing with ethic questions 99% of them require the answer that is the most empathetic, level-headed, and benevolent. Basically which answer tucks your tail between your leg and makes you "The perfect doctor"