1. A primigravida woman experienced atonic postpartum hemorrhage after an exhausting labor and emergency cesarean section, requiring a cesarean hysterectomy. Her husband consented to the procedure but her relatives later asked the doctor not to inform the patient of the hysterectomy. 2. A woman with a history of multiple cesareans was found to have a morbidly adherent placenta. She reluctantly consented to a possible cesarean hysterectomy. A hysterectomy was performed during her cesarean section after obtaining consent from her husband due to massive hemorrhaging. 3. A woman in labor experienced an abnormal CTG pattern but the registrar did not

1. PROCEDURE INSTRUCTIONS FOR CANDIDATES
SPECIALTY Obstetrics & Gynaecology
STATION NO:
STATION TITLE:
TIME ALLOWED: 6 minutes
DESCRIPTION OF THE TASK TO THE CANDIDATES:
Please read the following scenario and select the most appropriate principle of ethics which
apply in this situation and discussed with the examiner on next station:
1. A 28 year old primigravida, unbooked admitted in advanced labour, she was in labour for
more than 24 hours. Exhausted cesarean section decided & done. The patient & relatives
were told about the serious condition of patients & complications that can occur, she
went into atonic postpartum haemorrhage all methods tried but cesarean hysterectomy
done consent given by husband. Next morning her relatives ask you not to tell patient
about hysterectomy
2. A 30 year old gravida 4 para 3, all previous cesarean section. Her antenatal
ultrasound examination suggested morbidly adherent placenta. She was
explained the possibility of cesarean hysterectomy; she was reluctant to have
hysterectomy. During cesarean section due to massive haemorrhage you
performed hysterectomy after getting consent from husband. What ethical
principle covers your decision.
3. A 30 year old gravida para 2 who has had 2 previous normal vaginal
deliveries, admitted in labour at 38 weeks. The labour room nurse informed
the register about the abnormal CTG pattern. The registrar was busy in
emergency and came after 45 minutes and decided cesarean section. Baby
born with poor APGAR score & in NICU on ventilator. Patients criticized
on delay of doctor’s arrival. What ethical principle is applicable here?
4. A 70 year old woman is admitted for laparotomy due to presumably
malignant ovarian mass. Her family ask you and request you not to disclose
the diagnosis to the patient, if the tumour is malignant. They are concerned
for her psychological well being.
5. A 18 year unmarried college student attends your clinic requesting
emergency contraceptive. She does not want her family members to know.
What is your ethical responsibility to give her medication or to deny or let
parents know? What ethical principle you will choose from above?