First read the case study below, and then answer the questions below.
CLINICAL CASE
Communicating with Patients about Harmful Behaviors
Commentary by Carol R. Schermer, MD, MPH
Come on in, Travis, said Dr. Kennedy. Looks as though that could be a nasty scrape.
Yeah, well thanks for working me in, said Travis, holding a bloody bandana to his head. Were laying sewer pipe for the city and the crane operator cant see us too well. A pipe grazed me going down, he said. I guess my timings off today. It kind of rang my bell.
Let me take a look. Dr. Kennedy, examined his temple and the skin around the orbital area and eye. I can patch this up for you, and then well send you for some X-rays.
While he was at work on Traviss temple, Dr. Kennedy asked for more information about the accident. Why is your timing off? Are you getting enough sleep? Were you hung over?
Maybe.
How many drinks do you have in a week? Dr. Kennedy asked calmly.
I dont know. I dont count em. Three or four a day maybe. Not on the job, though. Travis replied.
Well I smell whiskey on your breath now and Im worried. You could have gotten a concussion down there todayor worse.
Easy on the sermons, OK? The other guys bought me one for the pain today. I can handle the drink, Travis said.
OK, Travis, said Dr Kennedy, exasperated. But we need to see what problems youre having that could be related to your drinking. You might need to cut back, and some people need to do that under supervision.
This case study scenario appears in the American Medical Association Journal of Ethics.
January 2008, Volume 10, Number 1: 13-16.
Case Study 1: Questions To Answer
- What are the ethical issues are presented in the case study scenario above? (5 points)
- The interviewing that takes place between Dr. Kennedy and Travis represents a brief intervention, and it is a motivational intervention.
a. Using the 4 steps of intervention design and delivery, consider a broader intervention design that could be employed by those in Dr. Kennedys practice. (Speak on the design, delivery and evaluation. Support your answer with information from the ASP text). (20 points)
- How might Dr. Kennedy slow down the intervention? He jumps quickly to suggesting professional help. Why is he doing that? (5 points)
4. List all the stakeholders) (5 points)
5. Finally, does Dr. Kennedy have a duty to disclose his findings to Traviss employer? Why or why not? (answer here from your opinion, you do not need to look up legal issues of doctors, employers, HIPAA laws etc.) (5 points)
Answer all your questions with the question number to which you are responding. Must be at least 3 pages (double spaced, 12 point font, 1 inch margins). Make sure to proofread your work. Spelling and grammar count. (10 points).
