Patient A, a 57-year-old male, was admitted to the ICU of a private hospital with kidney and liver failure, and in a coma. There was no living will and family members gave a history of long-standing alcohol abuse.

“Respect for the autonomous choices of persons runs as deep in common morality as any principle.” – TL Beauchamp and JF Childress, Principles of Biomedical Ethics (2001)

The GMC states that “Whether or not you have vulnerable children or young people as patients, you should consider their needs and welfare and offer them help if you think their rights have been abused or denied.” Surgery consultations, home visits, accident and emergency admissions and contact with other professionals who work with children help to build up a picture of a child’s situation.

A doctor’s primary concern is to do their best for their patients; this includes giving advice and treatment, and arranging investigations in accordance with the current evidence base and the patient’s best interests.

Mrs Y, 38, was admitted to hospital under the care of consultant Dr F for treatment of anaemia due to excessive menstrual bleeding. A sample of her blood was taken for grouping and cross-matching, for the purpose of a blood transfusion; a pack of compatible A-positive donor blood was sent to the ward for this purpose.

Mr M, a 51-year-old primary school teacher, was referred to ophthalmologist Mrs C, following a letter sent by an optometrist to his GP. The optometrist had found Mr M to have an abnormal right optic disc, slightly raised intraocular pressures and significant defects in the visual fields of his right eye with suspected glaucoma.

Miss T was 17 years old and still at college when she became pregnant with her first child. She gave birth to a healthy baby boy at term, and was discharged the following day, with planned midwifery follow-up at home. At one month old, Miss T became concerned that her infant, baby T, appeared to be having occasional odd movements of his left hand.