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Retired NBME 23 Answers

 +9  upvote downvote
submitted by dr.xx(176)
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right. he absolutely must remain in the waiting area so that he is at hand to attack his wife whenever her exam ends. go NBME!

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meningitis  I guess it was all about not offering battering information in order to not make matters worse since he will figure out that the wife told on him.. Also, its a HUGE STRETCH but the only reason I thought he should stay in the waiting room was just in case the wife died they could detain him and call the police for questioning. +11
temmy  Also, he should stay there because his wife did not grant him the permission to see him. Patients requests trumps. +3
nephcard  Doctor should not believe what wife told her. There may be some other reason for injury so batttering information should not be provided. But her wish of not letting her husband in should be fulfilled +2
charcot_bouchard  No. In real life patient lies. In Board ques they always tell the truth. Unless they make it very obvious. in fact its a board ques rule. So u believe her untill proven otherwise. +7
drdoom  The prevailing rule of American medicine and law is individual autonomy. No other person is granted “default access” or privilege to another person’s body—that includes the physician! The physician must receive consent from a (conscious) “person” before they become “a patient”. In the same way, the person (the patient) must give consent before anyone else is permitted to be involved in her care, spouses included! +



 +1  upvote downvote
submitted by paperbackwriter(161)
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Obviously you wouldn't allow the husband inside, but after staring at this question for way too long, I reasoned that you wouldn't tell him to leave for 2 reasons:

  1. It might clue him in to the fact that she told you about the abuse, and he will leash out on her if he gets the chance.

  2. If she wants to call the police and press charges it will be better that you know where he is.

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123ojm  it's your first point. unless the patient has a foolproof escape plan for when she is discharged, you don't want the husband to know that she told you about the abuse. that will put her in more danger. +



 +1  upvote downvote
submitted by usmle11a(102)
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ok the way i looked at this was:

youre not 100% sure she was attacked nor do you want to be the person telling the husband hes an attacker so you remove: B C

allowing him in with the patient, god knows what that guy has hidden with him also you will make a huge scene : A

the only thing to do is be diplomatic as people know they arent allowed in the treatment area and by that you assure her saftey.

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drdoom  The prevailing rule of American medicine (and law) is individual autonomy. No other person, professional or otherwise, is granted “default access” or privilege to another person’s body—that includes the physician! The physician must receive consent from a (conscious) “person” before they become “a patient”. In the same way, the person (now, the patient) must give consent before anyone else is permitted to be involved in her care—spouses included! +1
llamastep1  Alright we got it! lol +2
123ojm  B and C are actually wrong because they put the patient in danger for when she is discharged and has to return home. she probably has things she needs in their home (eg passport, money, etc) and if the husband knows she has told you about the abuse she is at risk of being killed. +



 +1  upvote downvote
submitted by drdoom(1206)
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The prevailing rule of American medicine (and law) is individual autonomy, otherwise known as liberty. In American law, no other person, professional or otherwise, is granted “default access” or privilege to another person’s body—that includes the physician! (It even includes spouses! That’s why, in American law, you can be married to someone and still be charged with sexual assault/rape; marriage ≠ your spouse surrendering “bodily rights”.) The physician must receive consent from “a (conscious) person” before they become “a (conscious) patient”. In the same way, the person (now, patient) must give consent before anyone else is permitted to be involved in his or her care—spouses included!

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