Centre for Military Ethics

Playing Cards

Medical Deck

Category: All
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Clubs Clubs Clubs Clubs 2 2 2 2
Ist es bei einem Unfall mit vielen Verletzten für eine Sanitätseinheit der Streitkräfte ethisch vertretbar, die Betten für eventuelle militärische Opfer leer zu halten?
Clubs Clubs Clubs Clubs 3 3 3 3
Die lokale Kultur oder der nationale Rechtsrahmen bieten nur einen schwachen Schutz gegen häusliche oder geschlechterspezifische Gewalt. Wie reagieren Sie auf eine schwer verletzte Frau, die Ihnen offenbart, dass sie vom Ehemann angegriffen wurde?
Clubs Clubs Clubs Clubs 4 4 4 4
Ein Opfer einer Vergewaltigung bittet Sie um Verabreichung einer "Pille danach" zur postkoitalen Empfängnisverhütung, welche Sie in Ihrer Apotheke haben. Die Anwendung ist jedoch im Operationsgebiet illegal. Was tun Sie?
Clubs Clubs Clubs Clubs 5 5 5 5
Unter welchen Umständen könnte es angebracht sein, lokale Spender zu nutzen, um Patienten in eines Lazaretts oder Militärhospitals mit Blut zu versorgen?
Könnten Sie sich jemals auf Blut oder Spender verlassen, die nicht vorab ausgewählt und untersucht wurden?
Clubs Clubs Clubs Clubs 6 6 6 6
When facing staff shortages, under what conditions may you use local volunteers without any medical training?
Clubs Clubs Clubs Clubs 7 7 7 7
How do you balance time taken for patient care with record keeping? What is the minimum information you should record?
Clubs Clubs Clubs Clubs 8 8 8 8
The command asks you in a routine situation to act in a capacity that your professional body would not recognise you as having the correct qualifications or training to perform.
What should you do?
Clubs Clubs Clubs Clubs 9 9 9 9
Clinical governance is not equal across organisations; how might you respond to an allegation that care in another nation’s medical facility is not clinically acceptable?
Would it/should it affect where you allocate cases?
Clubs Clubs Clubs Clubs 10 10 10 10
What should a health care professional do if faced with an order from a commanding officer requiring them to violate the principles of medical ethics?
Clubs Clubs Clubs Clubs J J J J
A talented and irreplaceable staff member is accepting bribes in order to prioritise patients for care.
How might this be addressed?
Clubs Clubs Clubs Clubs Q Q Q Q
A badly injured enemy combatant claims that his injuries were caused after he had been captured.
How do you respond?
Clubs Clubs Clubs Clubs K K K K
Your local military commander asks for off duty medical personnel to contribute to guarding the perimeter of the military compound.
How do you respond?
Clubs Clubs Clubs Clubs A A A A
Special forces capture a combatant who, they believe, has vital information about a future terrorist attack. The combatant refuses a life-saving treatment stating that he would “rather die than live as a prisoner and traitor”.
What can/should you do?
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Spades Spades Spades Spades 2 2 2 2
Violent non-state actors may recruit under-18s into their forces.
What are the duties of medical personnel towards 'children' as combatants?
Spades Spades Spades Spades 3 3 3 3
In order for you to get access to the wounded and sick, you have to share information with the host-nation authorities and/or the UN about the identities of the patients in your care.
Do you share the information?
Spades Spades Spades Spades 4 4 4 4
How do you decide the first person to treat or the allocation of single resources between two casualties with the same triage score?
Spades Spades Spades Spades 5 5 5 5
A badly injured, unaccompanied female child has been left at your emergency department.
What are the ethical challenges associated with consent for treatment and how might you address these?
Spades Spades Spades Spades 6 6 6 6
You suspect the host-nation base guards are refusing some people access to healthcare because they are from the 'wrong' area or tribe.
What do you do?
Spades Spades Spades Spades 7 7 7 7
You have evidence a government is committing atrocities against its own citizens. Should health care personnel allow media access to the patients in order to publicize the alleged crimes?
What else could a health care professional do?
Spades Spades Spades Spades 8 8 8 8
There is a shortage of beds and you have a stable but ventilated patient who can be moved to a local hospital but you know there are no nurses on night shifts. This could mean a death sentence.
What do you do?
Spades Spades Spades Spades 9 9 9 9
The divorced parents of a very badly injured soldier in your base hospital refuse to be present together but each insists that only they can speak on behalf of their son.
His brain injuries are such that he is not competent to consent to medical treatment. How do you resolve this?
Spades Spades Spades Spades 10 10 10 10
Should you allocate extra support to people with disabilities during an emergency evacuation if that means expecting apparently able-bodied people to manage by themselves?
Spades Spades Spades Spades J J J J
The husband of a badly wounded female refuses to permit your male medics to treat her.
What do you do?
Spades Spades Spades Spades Q Q Q Q
A distraught local national father refuses to allow the transfer of his badly injured daughter to another allied medical unit where more appropriate care can be provided.
What do you do?
Spades Spades Spades Spades K K K K
If you were faced with limited resources, how would you balance palliative care priorities with pain relief for incoming trauma patients?
Spades Spades Spades Spades A A A A
With modern medicine it is possible to save the lives of people with devastating injuries that will profoundly change their lives forever.
Are there limits to how far treatment should be taken? Who decides?
x
Hearts Hearts Hearts Hearts 2 2 2 2
Faced with an outbreak of a highly infectious disease, you have insufficient PPE for every patient-facing clinician, though you have adequate supplies of equipment used for normal infection control.
To whom do you allocate the higher level of protection? Do you require everyone else to continue working with the lower level equipment?
Hearts Hearts Hearts Hearts 3 3 3 3
Can military medical staff be ordered to deliver care if doing so involves severe risk of injury or death to themselves?
Hearts Hearts Hearts Hearts 4 4 4 4
You are deployed to a conflict area where the enemy are deliberately and consistently violating the laws of armed conflict. You have been tasked to send an ambulance on a very dangerous mission to collect enemy casualties.
Should your own personnel be put in harms’ way to save the life of someone who would not reciprocate?
Hearts Hearts Hearts Hearts 5 5 5 5
You are struggling to justify your country’s involvement in a war you believe to be unwinnable.
How do you cope?
Hearts Hearts Hearts Hearts 6 6 6 6
Your team has been working under intense conditions for days; you are all sleep-deprived and are making errors that put patients at risk. There is no back-fill support available.
As team leader, what is your duty of care to protect your team and yourself?
Hearts Hearts Hearts Hearts 7 7 7 7
Pre-deployment you had concerns about a colleague struggling with his mental health after multiple tours of duty. His performance is erratic. One day he seems fine the next he is making preventable errors.
His surgical skills are desperately needed. What can you do?
Hearts Hearts Hearts Hearts 8 8 8 8
Inevitably, the delivery of health care in conflict means not everything goes the way you would like or had planned, even when you have tried to do everything right.
How do you manage a sense of failure e.g. a patient death or a missed diagnosis?
Hearts Hearts Hearts Hearts 9 9 9 9
You are in a convoy that drives past the aftermath of a roadside bomb. Several local nationals are in need of emergency care. The commander orders you not to stop because the road is dangerous and there is a risk of being attacked.
Is the commander right?
Hearts Hearts Hearts Hearts 10 10 10 10
Can medications be used pending regulatory approval or ‘off label’ for non-licensed indications to save the lives of military personnel?
Hearts Hearts Hearts Hearts J J J J
Is it acceptable to allow firearms into a medical facility?
If so, who may carry them?
Hearts Hearts Hearts Hearts Q Q Q Q
A local patrol commander tells the attached medical personnel to remove their Red Cross arm bands because this disrupts camouflage.
Is this acceptable?
Hearts Hearts Hearts Hearts K K K K
The commander of a logistic convoy wishes to put food and water into the ambulance of the convoy.
Should this be permitted?
Hearts Hearts Hearts Hearts A A A A
When faced with an infectious disease outbreak, should military medical personnel be willing to accept greater risks than civilian medical workers?
x
Diamonds Diamonds Diamonds Diamonds 2 2 2 2
You will lead a medical unit and have a one week pre-deployment training period together in the country capital before setting up the unit.
How might you communicate to the team members before you meet them, and what ground rules would you wish to establish?
Diamonds Diamonds Diamonds Diamonds 3 3 3 3
You will lead a medical unit. 3 countries have agreed to provide medical personnel.
What cultural barriers might challenge the creation of successful team dynamics and how might you address these.
Diamonds Diamonds Diamonds Diamonds 4 4 4 4
You will lead a medical unit. There may be differences between members of the team. What characteristics are 'protected' under discrimination law?
How might you respond to an allegation of direct discrimination by one of your team members?
Diamonds Diamonds Diamonds Diamonds 5 5 5 5
You will lead a medical unit. There is a risk that poor communication across the team could result in patient harm.
How might you set up a system to review adverse clinical events that could sensitively identify weakness in teamwork?
Diamonds Diamonds Diamonds Diamonds 6 6 6 6
Your new unit has had its first Mass Casualty event. The following day, a senior male intensive care nurse takes you to one side and tells you that he refuses to work with the female orthopaedic surgeon as she is rude and incompetent.
What do you do?
Diamonds Diamonds Diamonds Diamonds 7 7 7 7
Four months into your tour as leader of a medical unit, your deputy comes into your office to tell you that senior members of your team are concerned about your mood and behaviour towards them.
What do you do?
Diamonds Diamonds Diamonds Diamonds 8 8 8 8
You will lead a medical unit. 3 countries have agreed to provide medical personnel.
How might you assess the credentialing and competence of each member of staff so as to ensure that they are suitably qualified for their role?
Diamonds Diamonds Diamonds Diamonds 9 9 9 9
You are conducting a daily round of ward patients and notice several new entries for a drug that is not in the hospital formulary.
The ward nurse explains that a new doctor has brought the drug as he wants to conduct a drug trial. What do you do?
Diamonds Diamonds Diamonds Diamonds 10 10 10 10
A Mass Casualty incident has just been called and the senior emergency department nurse cannot be found. After 30 mins, you are told that he is in his bed and refusing to come out.
What do you do as the team leader?
Diamonds Diamonds Diamonds Diamonds J J J J
Four months into your deployment, you are told that a fourth country will be sending a medical team to work in your unit to treat their casualties because of complaints about medical care.
What do you do?
Diamonds Diamonds Diamonds Diamonds Q Q Q Q
You are the leader of a multinational medical unit. One country’s leader insists they will wear national uniform and refuses to allow her personnel to wear the set of surgical scrubs that all personnel wear when on duty in a clinical role.
What do you do?
Diamonds Diamonds Diamonds Diamonds K K K K
You will lead a medical unit. The leader of one contingent insists that his country has agreed to provide 'one shift' in a three-shift system and will not allow rostering at department level.
What do you do?
Diamonds Diamonds Diamonds Diamonds A A A A
Reguläre Selektierungs-Protokolle können eine sich rasch entfaltende Unfallsituation mit hohen Opferzahlen nicht bewältigen.
Wie erreichen Sie Zustimmung in Ihrer Sanitätsgruppe für die Entscheidungen, die getroffen werden müssen?
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Joker Joker Joker Joker 2 2 2 2
Core Principles from the Geneva Conventions
Covers: the conduct of armed conflict, protection for those not involved in armed conflict (plus medical units and transport), and protection for those unable to participate in armed conflict (wounded, sick, shipwrecked and prisoners)
Joker Joker Joker Joker 1 1 1 1
The Four Principles of Medical Ethics
Beneficence, Justice, Autonomy and Non-malificence