Ethical Dilemmas in Interviews

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PopuriofHM

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So, I haven't had any medical school interviews yet, but my school does a mock interview with the pre-med committee prior to writing a committee letter of recommendation (I assume this is pretty standard). I wasn't well prepared for this interview, and they threw in a lot of ethical dilemmas such as:

A child needs a blood transfusion, but his parents are Jehovah's Witnesses, and their religion prohibits it. The boy will die without the transfusion. What do you do?

-and-

You perform a physical for a pilot and find that he has mild seizures. Do you report this to the airline he works for?

For questions such as these, I explained both sides of the argument, and took a very neutral position, taking into account doctor-patient confidentiality and the will of the patient. However, at the conclusion of my interview, the committee informed me that they were trying to get me to make a decision because that's what a doctor does. My question is, in med school interviews is it better to take a side or stay neutral during ethical dilemma questions?

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Absolutely take a position, but it should be something you honestly believe and not something you think the interviewer wants to hear. They want to see that you have a personal code of ethics and are able to reason through difficult decisions and it is unlikely that they are looking for any one "correct" answer.
 
So, I haven't had any medical school interviews yet, but my school does a mock interview with the pre-med committee prior to writing a committee letter of recommendation (I assume this is pretty standard). I wasn't well prepared for this interview, and they threw in a lot of ethical dilemmas such as:

A child needs a blood transfusion, but his parents are Jehovah's Witnesses, and their religion prohibits it. The boy will die without the transfusion. What do you do?

-and-

You perform a physical for a pilot and find that he has mild seizures. Do you report this to the airline he works for?

For questions such as these, I explained both sides of the argument, and took a very neutral position, taking into account doctor-patient confidentiality and the will of the patient. However, at the conclusion of my interview, the committee informed me that they were trying to get me to make a decision because that's what a doctor does. My question is, in med school interviews is it better to take a side or stay neutral during ethical dilemma questions?

Take the moral high ground and defend it. It's harder to lose that way.
 
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Any answer with an intelligent reason would have sufficed.
 
Always do the right thing. :)

The state has its interests in protecting the child's life. This interest exceeds the right of the parents to consent to the child's treatment. In other words, if the child is in danger of losing his life, you don't need the parental's consent--by law. It may seem odd that you would first seek parental consent which you can later ignore. But for the child safety, respecting his personal right to life, you just give him/her treatment.

The right of the confidentiality of the patient ends where the safety of others begins. Encourage the pilot to seek a different jobs and to quit his job. If he is not willing, it is up to you to report him. If you know that his seizure will impair his ability to perform his job, endangering the life of others, the decision is pretty obvious. In fact, I would go so far as to say that---if you don't report him--you are the one liable if anything happens to people aboard his plane.

So, I haven't had any medical school interviews yet, but my school does a mock interview with the pre-med committee prior to writing a committee letter of recommendation (I assume this is pretty standard). I wasn't well prepared for this interview, and they threw in a lot of ethical dilemmas such as:

A child needs a blood transfusion, but his parents are Jehovah's Witnesses, and their religion prohibits it. The boy will die without the transfusion. What do you do?

-and-

You perform a physical for a pilot and find that he has mild seizures. Do you report this to the airline he works for?

For questions such as these, I explained both sides of the argument, and took a very neutral position, taking into account doctor-patient confidentiality and the will of the patient. However, at the conclusion of my interview, the committee informed me that they were trying to get me to make a decision because that's what a doctor does. My question is, in med school interviews is it better to take a side or stay neutral during ethical dilemma questions?
 
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Careful here, it's not always so cut and dry. It's fine to take a strong position, but make sure you recognize that there are shades of gray as well (which the OP maybe did too much of, and the above poster not quite enough). For example.

In other words, if the child is in danger of losing his life, you don't need the parental's consent--by law. It may seem odd that you would first seek parental consent which you can later ignore.

What if the parents don't want to give their kid a vaccine? I can't force it on him, even if there happens to be rubella around that he could catch and kill him. Respecting patient's autonomy is important, I can't just go around doing what I think is best for people's kids whether they like it or not.


The right of the confidentiality of the patient ends where the safety of others begins.

Yikes. So if a patient has herpes should he be required to wear a mask, chastity belt, and t-shirt that says 'I have herpes, for your own safety stay out of range of my secretions!'. There are a bunch of little legal loopholes in confidentiality (the mandatory reporting of infections diseases also comes to mind), but I wouldn't make my stand that anyone who could possibly pose a harm to others deserves to have their dirty laundry aired.

There aren't right or wrong answers here, and I think the OP got that nicely. But in real life, you're still going to need to make decisions, and in that sense the "what would you do?" question is a little different than a straight 'ethical dilemma' type question. After I discussed the shades of gray, I'd make sure to tell them how I'd go about the situation in real life.
 
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I'm speaking of the specific situation here-- where the child is clearly in danger of losing his life. At that point, we do not need parental consent for minors. Would you agree with that? Vaccines are different than situations that require acute treatment.

And for STDS, herpes is different. You can't eradicate it or treat the partner, so there is no contact tracing or notifying or treating of the patient

But in the cases of AIDS, Gonnorhea or syphillus. If John has these, and refuses to tell his partners, you have the responsibility to tell their partners, wouldn't you agree? And this doesn't involve breaching John confidentiality. This problem can be reported by the health department, who will notify his partners without disclosing the identity of the source.

But I will admit that I was a bit too cut and dry. But I think the situations here are pretty straightforward, correct me if I'm wrong.
 
For the first one, I believe the correct action is to go ahead and do the blood transfusion. You don't need parental consent. The child will temporarily be in state's custody until the procedure is complete. So if the parents want to sue, they have to sue the state.

And for the second one, I think you have to report it too. You have to respect the patient's confidential unless he/she is in risk of harming other people or self.
 
For the first one, I believe the correct action is to go ahead and do the blood transfusion. You don't need parental consent. The child will temporarily be in state's custody until the procedure is complete. So if the parents want to sue, they have to sue the state.

And for the second one, I think you have to report it too. You have to respect the patient's confidential unless he/she is in risk of harming other people or self.

I agree that in the first situation, state takes temporary custody of the child and consents to transfusion. If it is life-threatening, you go ahead and do it. If it's not a life-threatening situation, you can wait for a court order.

For the second one, you try to convince the pilot to report it himself, but if you see that he insists on not telling his airline, you also have the duty to report it.
 
For the second one, you try to convince the pilot to report it himself, but if you see that he insists on not telling his airline, you also have the duty to report it.

I disagree. In this case you follow the law. If it's legal to let the airline know about his problem, you do it, if not it's his obligation to report it. This is especially true if he's taking medication to prevent his seizures.
 
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For the first one, I believe the correct action is to go ahead and do the blood transfusion. You don't need parental consent. The child will temporarily be in state's custody until the procedure is complete. So if the parents want to sue, they have to sue the state.

there's no "automatic" transfer of custody to the state in the event parents refuse to consent to treatment for their child. at least I've never heard of such a thing. the hospital first needs to get a court order. this can be done fairly quickly, sometimes even via phone (there's usually a judge designated to be on call for this sort of thing).
 
I disagree. In this case you follow the law. If it's legal to let the airline know about his problem, you do it, if not it's his obligation to report it. This is especially true if he's taking medication to prevent his seizures.

this would imply he has already been seen and cleared by the proper physician though, right?
 
@lessH8 will you stop bumping 10 year old irrelevant threads?

Edit: I just saw your post history and that you only just joined. I apologize for being harsh, I had you confused with someone else and didn’t realize you’re a brand new user. Not the best welcome, I’m sorry!

In the future, take a look at the last posted date when you’re replying and make sure it’s actually a recent thread. Unlike some forums SDN doesn’t automatically lock older threads, so people often inadvertently post on 10+ year old topics because they come up as related or on a search.
 
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