Master the board step 3

Master the Boards: USMLE Step 3
Capacity
Capacity is determined by physicians. Competence is a legal term and is determined
by courts and judges. An adult who is alert and not mentally handicapped
is deemed to have capacity to understand her own medical procedures
and treatments.
Psychiatry Consultation
“Psychiatry consultation” is the answer when a patient’s capacity to understand
is not clear. A psychiatry consultation is not necessary in the following
situations:
··
The patient is clearly competent.
··
The patient is in a coma and clearly does not have the capacity to understand.
Minors
Minors, by definition, are not determined to have the capacity to understand
their medical problems until the age of 18.
However, Step 3 does like to test your understanding of the emancipated
minor. Emancipation means that although the patient is under 18, he can
make his own decisions. Emancipated minors are living independently and
self-supporting, married, or in the military.
Partial emancipation is considered to be present for the following issues:
··
Sex
··
Reproductive health
··
Substance abuse
If the patient is a minor and seeks treatment for contraception, sexually
transmitted diseases, HIV, or prenatal care, she is partially emancipated. In
other words, she can make these decisions on her own, and her privacy is to
be respected like that of an adult. An exception is abortion: 36 states have
parental notification laws for abortion.
How does USMLE get around issues that are not universal across the United
States? For such questions, the answer is a safe, universally correct answer, such
as “Recommend that the patient inform the parents.”
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