Table 2

Vignettes

*These vignettes were adapted from a previously validated instrument.8 9
*Brain Haemorrhage case: A 58-year-old male has suffered an extremely large haemorrhage in the left side of his brain and requires life support and surgical intervention to survive. He has previously discussed with his family his wish never to be placed on life support. However, his wife wishes to have “everything” done for her husband.
*Deteriorating Health case: You visit an 82-year-old female who has been previously healthy and independent. She has been deteriorating for five weeks, has lost weight, is mildly delirious, and has taken to her bed. You think she needs to come into hospital for further investigation, but she adamantly refuses.
Huntington's Test case: A 38-year-old married man is at risk for Huntington's disease, a degenerative genetic disease of the nervous system that manifests itself around age 40. Given his family history, his three children and siblings are also at increased risk. Right now he has no symptoms, but requests genetic testing due to his increased risk. The test reveals that he has the Huntington's gene and will develop the disease. His insurance company requests his test results from the physician who arranged for the testing to be done.
*Lung Tumour case: A hospitalised 45-year-old widower had tests that reveal an inoperable malignant lung tumour. He is likely to die within the next six months. He has a past history of depression and is currently on anti-depressant medication. His adult children have told his physician that he cannot handle “bad news” and have requested that under no circumstances should he be informed of his diagnosis.