Paediatrics: Clinical case study

Clinical case study

During clinical practice, as a postgraduate trainee or an undergradu-ate medical student, there are many opportunities to consider some of the common ethical and legal issues at the core of paediatrics and child health. In order to help with consolidating this aspect of your learning we suggest that you undertake this clinical case study. First, identify a case that has caused you to think. There are then 4 steps. In the first two you note your initial thoughts. Step 3 is completed after a case discussion conference with your team and other learners. Step 4 is for your refl ec-tion. Write down a summary of each step—it will help to clarify your thoughts and you shouldn’t need more than 250 words for each of the sections in Box 31.2.

Box 31.2 Steps in a clinical case study

Step 1. Clinical vignette

Describe the key issues in your patient or scenario:

·  The medical facts?

·  Contextual factors?

·  The patient’s capacity?

·  The child’s preferences?

·  Surrogate decision makers?

·  Competing interests?

Step 2. Medical, ethical, and legal issues

·  What problems are posed by the case or scenario?

·  What options were there for resolution?

Step 3. Clinical goal-setting and decision-making

After you have had an opportunity to discuss steps 1 and 2 in a group:

·  Write down what you discussed in the group

·  Was there an answer or resolution to the problem?

·  How was this achieved and what options or interventions were considered?

Step 4. Implementation and evaluation

·  How was the matter dealt with?

·  Comment on whether the plan of action worked

·  In retrospect, do you think the problem could have been avoided or improved, etc.?