GP Stage 3 Simulated Consultation - Relative 1
You are an FY2 working in a GP Surgery, Mr Mark Andrews has come to speak to you about his son Jonathan, 19 who is also a patient of yours and was recently diagnosed with metastatic testicular cancer.
You are Mr Mark Andrews and you have come to the GP surgery to discuss your concerns about your son, Jonathan (19 years old). Jonathan was recently diagnosed with testicular cancer and after completing online research, he has decided that he would like to proceed with an alternative medicine treatment approach. You feel that you are to blame for Jonathan’s decision as you have long criticised doctors in his presence, following the death of your mother.
If further probed, you report that the alternative medicine approach that Jonathan has decided involves taking cannabis. On disclosing this, you request assurances that the consultation is fully confidential and that the doctor will not be reporting Jonathan to the police.
You are unaware that Jonathan’s testicular cancer is metastatic (has spread beyond the testes) and if inadvertently told, demand further information, insisting that it is your right as his father.
At home, you live with your wife and Jonathan. Your wife (also registered at the GP practice) is having a difficult time accepting Jonathan’s decision, and is becoming increasingly withdrawn and depressed as a result. You are presently not working and spend most of the time at home with your wife and Jonathan. You would like the doctor to persuade Jonathan to pursue a more conventional treatment approach.
This consultation requires sensitive probing with confidentiality on two fronts. On one front, it is important not to disclose any additional information regarding Jonathan’s diagnosis (given that you do not have explicit consent) and equally it is important to reassure Mr Andrews that his disclosures will remain confidential.
Good candidates will encourage Mr Andrews to discuss his concerns with Jonathan in order to encourage Jonathan to attend the surgery, although making it clear that whilst clinicians can advise competent adults regarding the available options, we not permitted to override or forcefully persuade their judgement. Excellent candidates will also note the significant family consequences of the current circumstances, and would potentially suggest support groups for family members of patients diagnosed with cancer, as well as recommending that Mrs Andrews arrange a GP appointment.