ethics, shmethics!

just got home from the first of my final assessments for the year.
today i had my MSATs (multiple station assessement tests). how can i describe this... basically it's a big bell-ringer exam where you jump from station to station (without breaks inbetween) completing the required task. each station is only 9 minutes long. you get 9 minutes of perusal time at the beginning and 1 "rest station". but if you're unlucky - like me - then your rest station comes at the end and is basically useless. so you have to be on the ball.

so for example, station 1 & 2 were history taking stations. i had to take a full history from a patient who had abdominal pain and then from one that had breathlessness & tightness of chest upon exertion. these were pretty easy. went through my NILDOCARRFIA (nature of pain, intensity, location, duration... etc) then knocked through some past medical history, some family history, social history/lifestyle, etc. all the while trying to build rapport.

station 3 was a clinical physical exam. this too was not too difficult. i had to check for all the pulses in the upper and lower limbs, note rate/rhythm/character. then i had to take the patient's blood pressure. also a piece of cake. but the proctor was a huge grump! he rushed me through everything, and just generally seemed unhappy about something.

station 4 was an ethics station. probably the hardest one. it went something like this:

ok. so it wasn't actually THAT. it was more like... "you are a GP. leanne a 15 year old has recently been by for an appointment. during this consultation, she had mentioned binge eating and purging on one occassion. you were unable to elicit more information about this behavior. today leanne's father comes in to discuss leanne." basically you're not supposed to tell the father that she was here. you're supposed to respect her confidentiality and her right to autonomy as a mature minor.
i botched this one.
i did tell him that she was here. but let me tell you why. the father had mentioned that...
1. he smelled vomit in the house bathroom
2. leanne's friend marlene's mother called the father to say that marlene saw leanne throwing up at a party
3. the father found a brochure on anorexia nervosa and bulimia with MY contact details in leanne's room.
so basically he knew she was here and bingin' and purgin'.
PLUS, from the trigger i wasn't too sure if i could deem her to be "competent". you see, for a minor to be competent they need to have sufficient understanding and intelligence to understand fully what is being proposed. however, anorexia is now considered a mental illness. if you have a mental illness, then you're no longer deemed competent. and ZIP, there goes your right (as a minor) to confidentiality.
AHHHHH! oh well.

station 5 was probably the easiest.
basically, find an unconscious patient & perform CPR. run through using an AED and inserting an oropharyngeal. not being cocky. but after all those lifeguarding inservices, i probably could've done this one in my sleep.