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Phase 3 Medicine 2026

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Learning activities

ix. Clinical Ethical Decision Making

Possible solutions and their justification

For our list of possible solutions, let's think about why these might be justified.

Shared decision making discussions to adequately inform the parents of the efficacy of different treatments and ideally continue chemotherapy:

so that the Court can reprimand the doctors for disagreeing with the parents.

❌

so that the child's well-being is of greatest priority. If parents won't agree, they may need to be removed from decision making.

❌

so that the parents may be convinced of the data supporting chemotherapy and that some alternative therapies can also be used.

✅

so that the doctors can force the parents to change their mind.

❌

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Bring the case to court in concern for the child's well-being to override parental authority:

so that the Court can reprimand the doctors for disagreeing with the parents.

❌

so that the child's well-being is of greatest priority. If parents won't agree, they may need to be removed from decision making.

✅

so that the parents may be convinced of the data supporting chemotherapy and that some alternative therapies can also be used.

❌

so that the doctors can force the parents to change their mind.

❌

View this question

Learning activities

ix. Clinical Ethical Decision Making

Now that we know the facts of the situation, let's identify and match the values of each of the stakeholders.

Doctors

Bella

Parents

The state

View this question

Learning activities

ix. Clinical Ethical Decision Making

Facts of the scenario

What do we know about the situation and who is considered a stakeholder? What would be some potential solutions?

Match the following:

Shared-decision making discussions to adequately inform the parents of the efficacy of different treatments and ideally continue chemotherapy

Parents believe diet and homeopathy to be as effective as chemotherapy (and less toxic)

Bella

The parents wish to stop their child's chemotherapy

The desire that a

treatment will result in a long-standing cure for their child

The State

Physicians

Bring the case to court in concern for the child's well-being to over-ride parental authority

Chemotherapy offers a conventional medical approach with high success rates

Bella has leukaemia

View this question

Learning activities

v. The child's 'best interests'

How are a child’s best interests determined?

Determining whether a decision is ‘in the child’s best interests’ in clinical situations is always going to be a subjective issue, though the courts have identified some factors that are likely to be relevant and important to consider in assessing a child’s best interests.

Clinical decision making ‘best interests’ activity: What are opinions and what are facts?

Match the following:

The degree of risk to the child of authorising or not authorising treatment

The nature of the treatment/procedure (what it involves)

The alternative courses of treatment available

The desirability of the treatment over the alternatives

The views of the child’s guardians or whoever is responsible for the duty of care

The chance a treatment will result in long-standing cure for the child

The reasons supporting the treatment

The effects of the treatment, compared to the alternatives

The significance of the risk to the child of authorising or not authorising treatment

The physical, psychological, and social implications of authorising or not authorising the treatment

The child's condition

The opinions of the child themselves (though the weight of the child’s view depends on their age and maturity)

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Learning activities

v. The child's 'best interests'

Case study question:

What was the ultimate decision/outcome of the court-case?

The parents were unable to provide consent and Marion was the only individual who could provide adequate consent for this procedure.

❌

The High Court decided parental authority did not apply to cases such as sterilisation, and the High Court made the ultimate decision.

✅

The parents’ decisions were deemed to be satisfactory and the procedure went ahead.

❌

The parents and medical authorities were given responsibility to decide the course of action, after a long period (6 months) of deliberation.

❌

View this question

Learning activities

iii. Handling of medical information under the age of 18

Mini quiz

Can parents automatically access the Medicare records of their child?

No - if the child is 14+ yrs and has their own Medicare card, they must give consent for their parents to access their Medicare records.

✅

Yes, because the child is in their care.

❌

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Which of the following statement/s about medical abortions

(MS-2 Step) is/are correct?

MS-2 Step is only available for prescription in NSW, Victoria, and the ACT

✅

MS-2 Step can be prescribed up until 9 weeks gestation

✅

MS-2 Step is available for prescription in all States across Australia

✅

MS-2 Step can only be prescribed by doctors in NSW

✅

MS-2 Step can be prescribed up until 12 weeks gestation

✅

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Clarissa is almost 16 years old, and she presents to her

General Practitioner. She is really in-love with her boyfriend who is in her

year at school but is very distressed to find out that she is pregnant. She

asks her GP for help to obtain an abortion. Which one of the following

statement/s is/are true?

Clarissa’s sexual partner must be involved in the decision about abortion

✅

If Clarissa is Gillick competent she can make her own decision about abortion

✅

Clarissa has not yet reached the age of consent so this must be reported to the law

✅

If Clarissa is less than 9 weeks pregnant, she can opt for a medical abortion

✅

Clarissa must inform her parents and obtain their permission for a medical abortion

✅

View this question

Termination of pregnancy is not

permitted according

to the NSW Abortion Law Reform Act (2019) under which of the following

circumstances:

The foetus has a sex-linked medical condition

❌

Sex selection

✅

A gestation over 20 weeks

❌

If the woman’s partner objected

❌

The foetus has trisomy 21

❌

View this question

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