Patient Care & Ethical Standards in Neurology Flashcards

Which statement about brain death determination in the US is correct?

Answer: Irreversible loss of all brain function, including the brainstem, is legal death

Under the UDDA, irreversible cessation of all functions of the entire brain, including the brainstem, is death.

Before testing for brain death, which condition must be excluded?

Answer: Hypothermia and drug intoxication

Confounders such as hypothermia, sedatives, and severe metabolic disturbances must be ruled out first.

A competent patient with a high spinal cord injury asks to stop mechanical ventilation. What is the ethically accepted response?

Answer: Honor the informed refusal and provide comfort care

Competent patients may refuse or withdraw life-sustaining treatment, and doing so is ethically distinct from euthanasia.

Giving opioids to relieve dyspnea in end-stage ALS, knowing they may shorten life, is justified by which principle?

Answer: Double effect

Under double effect, a foreseen but unintended harm is allowed when the intent is to relieve suffering.

A patient with epilepsy keeps driving despite uncontrolled seizures. What is the clinician's best first step?

Answer: Counsel the patient on driving restrictions and record it, following state reporting laws

Clinicians must counsel and document, and reporting duties vary by state, with only some states mandating physician reporting.

Which neurological test result most strongly calls for genetic counseling before it is disclosed?

Answer: Predictive testing for Huntington's disease in an asymptomatic adult

Presymptomatic Huntington's testing has major psychological impact and needs pre- and post-test counseling.

An unconscious stroke patient needs emergency thrombolysis and no surrogate is available. Which consent doctrine applies?

Answer: Implied (emergency) consent

In emergencies where a delay would cause harm, implied consent lets clinicians give standard care.