Ethics in General Practice
SUKHIT PHAOSA V ASDI, MD*, SURASAK TANEEPANICHSKUL, MD*, YUEN TANNIRANDORN, MD*, CHUMSAK PRUKSAPONG, MD**, AURCHART KARNJANAPITAK, MD***, PINIT KULLA V ANIJAY A, MD****
Affiliation : * Member of Thai Medical Association. **Director General of Instiute of Forensic Science. *** Member of the Royal College of ENT, Deputy Secretary General of Medical Council. **** President of the Royal College of Physicians of Thailand, Secretary General of Medical Council.
A female patient of 42 years old, married for 4 years, childless but with one abortion and without any birth control has been investigated for infertility at a private hospital. However, she did not attend the infertility clinic regularly because of the high cost. Her present story that her menstrua tion was late for 7 days and the pregnancy test was positive. She came to consult whether she needs to have injections to strengthen her pregnancy as she is afraid of having an abortion again. Her urine was tested again for pregnancy and this is still positive. She did not want to have per vaginal exami nation as she was afraid it might disturb the pregnancy. She agreed to having ultrasound instead and this showed the uterus seemed to have some fluid simulating pregnancy. The wall of the uterus has a small tumour of about 1 em in size. The right ovary appears cystic, with uneven surface of 3 em in size. Inside the cyst there is a stalk sticking out. The left ovary is a smooth cyst about 2 em in size and there is fluid in the peritoneal cavity around the left ovary. After the ultrasound the patient gave further information that about 2 weeks ago she received 2 units of blood through her social security right because she was anaemic and 10 days ago she went to receive help regarding infertility at a governmental university hospital where she received advice to have an operation for the pelvic tumour. Whilst waiting for the operation she was found to be pregnant as stated. If you are consulted by this patient what advice will you give regarding the medical ethics (please send in your thoughts)?
Keywords : Ethics, General Practice
