A 37-year-old man comes to your office for his regular visit. He has seemed severely depressed for some time but refuses to discuss either his feelings or treatment options of any kind. He does not want to use antidepressant medications. His only medications are vitamins. Your relationship with him is excellent but he just won't confront his feelings of depression although he firmly denies suicidal ideation. You prescribe a serotonin reuptake inhibitor for him and tell him that it is a vitamin. Over the next several months his mood markedly improves and he feels much better. Which of the following most appropriately characterizes your action toward the patient?

Correct Answer: D

Rationale: A patient must give consent to any test or treatment performed upon him as long as the patient has the capacity to decide. Physicians are not acting ethically when they treat a patient without his consent even if it benefits the patient. It is very difficult for some people to accept that goodwill and sincerity are not sufficient to override the absolute necessity for informed consent. This is true even if you are right in the sense that the treatment will help the patient and that only the patient will benefit from the procedure or treatment. This is true even if payment is not received. Autonomy of the individual outweighs beneficence, which is the desire to do good. This is the physician's desire to treat the patient. Another way of saying it is: I have a right to be sick and miserable if that is what I want.

Correct Answer: B

Rationale: Consulting the nurse ensures appropriate treatment, as medications must match the ordered indication.

Correct Answer: C

Rationale: Nitroglycerin is given sublingually for rapid relief of angina via quick bloodstream absorption.

Correct Answer: A

Rationale: These are antipsychotics used for mental illnesses like schizophrenia.

Correct Answer: A

Rationale: Reporting to the nurse allows for evaluation of potential side effects like sedation.