Pearl and Dean have been married for 12 years and have a 6-year-old son. Dean’s father and grandfather died from cancer when they were in their early 40s. Because of the strong family history of cancer, Dean wanted to have a genetic test to find out his level of risk. Although no clear diagnosis was […]
Doug is 51 and married with three adult children. He has been treated by his GP for depression for the last 7 years. More recently he has developed abnormal facial movements and spasms in his legs which are occurring at rest. The GP suspected that his low mood and lethargy over the past 7 years […]
A 40-year-old woman, has come to see you to discuss treatment for menorrhagia. She was born with congenital deafness and has brought her 16-year-old son with her to act as an interpreter. She lip-reads a little but feels more comfortable using sign language. The patient tells you that she has had enough of her heavy […]
A 25-year-old white man with no symptoms, attends the genitourinary medicine clinic. He reports that his boyfriend of 2 years, has advised him to attend. He says he was diagnosed and treated for syphilis the week before at the same clinic. This patient has had no other partners since his last negative tests 2 years […]
One of your patients has recently died from ovarian cancer. She had presented to the surgery twice with vague symptoms prior to being referred for an ultrasound scan which demonstrated advanced cancer. Despite aggressive treatment with chemotherapy and surgery, she died less than 6 months after diagnosis. Her family is understandably distraught, and her daughter […]
A 17 and has an inherited metabolic disease. She has been attending a specialist clinic on a yearly basis for monitoring. Sometimes she attends with her parents, although patients are encouraged to increasingly take an independent approach. At the latest appointment this patient specifically asked to speak to the consultant without her dad being present. […]
A nurse working on an orthopedic ward has established a rapport with a patient who has been admitted under the orthopedic team for surgical repair of a fractured wrist. The patient told the consultant that her injuries were sustained falling down the stairs. However, during a chat with the nurse, she asks ‘is everything I […]
A 46-year-old man lives in a nursing home has a severe learning disability, and the nursing home provides one-to-one nursing and care support for him. Although he does wander around the home on occasion, he has never tried to leave the nursing home, and the nursing home staff report that he seems happy and free […]
Alice is 45 years old, and following viral encephalitis she has been left with severe neurological impairment with no prospect of improvement. She cannot move or speak and is entirely dependent on others for care. She is receiving clinically assisted nutrition and hydration. Alice was close to her father and sister and long-term partner. She […]
You are a Year 5 specialist trainee (ST5) in obstetrics. You have been asked to review a patient by her midwife. The woman is a 30-year-old Polish lady in labor. This is her first pregnancy and she is full term. The midwife has established that her husband is on his way in. Her grasp of […]
Camille M. Renella, RN, CME, LNC
Clinical Medical Ethicist/Legal Nurse Consultant
Institute of Medicine Chicago (IOMC) Fellow
Executive Director