CHAPTER 2 EXERCISES:
COUNSELING AND INFORMED CONSENT
EXERCISE 2.1: Pregnancy options counseling and screening
Purpose: The following exercise is designed to review pregnancy options counseling. Consider role-playing the following scenarios.
1. A person you see for care presents with an unexpected positive pregnancy test during a health center visit or in the ED. How would you approach this?
2. When you ask what questions an individual has, they want to know if an abortion will affect their ability to have children in the future. How would you respond?
3. An individual is leaning towards adoption but is trying to decide and wants to know more about the process and options. How would you respond?
4. While you are explaining the MAB protocol, a patient mentions that their boyfriend “absolutely cannot find out about this pregnancy.” What concerns does this raise, and how can you explore the situation further? What assurances can you give them, and what support may you want to offer them?
5. You receive a phone call from a man who would like to schedule an MAB for himself. What questions should you ask during intake and counseling?
6. You are seeing a 19-year-old who has been to the health center for several abortions in the past. Their first abortion was when they were 14. They are always accompanied by an older male relative. You are concerned they may be the victim of sex trafficking. What questions might you ask? What should you do if you find out they are the victim of trafficking?
EXERCISE 2.2: Counseling around clinical care
Purpose: Discuss what you might say to the person in each of the following situations.
1. As you enter the exam room, you hear a partner criticizing the person for “acting stupid” and telling them angrily to “just shut up.” The partner is looking at the wall and ignores your efforts to introduce yourself.
2. When you come into the room and ask how the person is feeling, they start crying uncontrollably. They turn their head away from you and do not make eye contact.
3. You have just completed a uterine aspiration for someone at 8 weeks gestation. They ask, “Can I see what it looks like?” How would you respond? How would your response stay the same or differ at 12 weeks gestation?
4. A person at < 14 weeks by LMP presents with bleeding to your health center. Which history questions are beyond clinical relevance and should be avoided to protect them from potential criminalization?
Optional Chapter 2 CME: