Ethical questions during interviews.

[cars321]

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I have heard that some schools ask ethical questions during interviews. I know that they often just ask them to see your reasoning and you should answer them based on personal preference. I am having a difficult time trying to answer some of them. Here's some examples if any of you guys can provide any advice.

- You are a doc in small town and 3 patients come in at the same time. The patients are all the same except for their occupation: one is a small town rural doctor, the 2nd is an employer that employs 10% of the town and the 3rd is a delivery guy. Out of these 3 patients who do you save in why?

Another example:

- You are an ER physician and two patients need dialysis but you can only give dialysis to one. One of the patients is a wealthy widower, the other is a young mother with 3 children. Who do you choose to give the dialysis to and why?.

These are just some examples I have come across. I am aware that questions like these may not be asked during an interview but rather would be prepared.

 

[rajaholick]

I dont generally prepare for ethical questions mainly because you never know what they're going to ask. Also, if you memorize answers to questions like this, when you're replying your answer will just seem ingeinuine.
Dont worry too much about the ethical questions. They rarely come up, and if they do just take a few seconds to think and reply as honestly as possible.
During one of my interviews i paused for 10-15 seconds to think of something mid sentence, but didn't worry too much about it because I knew that thinking before answering would've been a lot better than just saying soething.

 

[Bacchus]

I have heard that some schools ask ethical questions during interviews. I know that they often just ask them to see your reasoning and you should answer them based on personal preference. I am having a difficult time trying to answer some of them. Here's some examples if any of you guys can provide any advice.

- You are a doc in small town and 3 patients come in at the same time. The patients are all the same except for their occupation: one is a small town rural doctor, the 2nd is an employer that employs 10% of the town and the 3rd is a delivery guy. Out of these 3 patients who do you save in why?

Another example:

- You are an ER physician and two patients need dialysis but you can only give dialysis to one. One of the patients is a wealthy widower, the other is a young mother with 3 children. Who do you choose to give the dialysis to and why?.

These are just some examples I have come across. I am aware that questions like these may not be asked during an interview but rather would be prepared.

Triage was set up for a reason. You decide who will have the best chance of survival and you treat that person. These situations hardly (I won't say never) happen, but in the event they do there is a systematic approach to who gets the treatment: Think organ recipients.

 

[scpod]

Triage was set up for a reason. You decide who will have the best chance of survival and you treat that person.....

Military triage is that way. For civilians it's usually worst first.

 

[Bacchus]

Sorry. That's what I meant, but if you have a 90 y/o and a 20 y/o you'll treat the 20 y/o, wouldn't you? Maybe?

 

[scpod]

Sorry. That's what I meant, but if you have a 90 y/o and a 20 y/o you'll treat the 20 y/o, wouldn't you? Maybe?

You'd treat both of them, but you'd probably get to the one who's most likely to die first and start with them. Your job in the ED is not to fix them in most cases, it's to keep them alive and stabilize them until someone CAN fix them.

In reality, though, that situation doesn't come up all that often. We have 29 ED beds, 10 fast track beds and two trauma beds. We're usually staffed pretty well. In the possibility of a mass casualty event there's a system in place to call in more help.

In the daily environment of the ED you assess a patient, give orders, and while those are being carried out you go see someone else. You carry multiple patients at any given time. You're typically waiting on images in one room, waiting on labs in another, waiting on the nurse to set up for an LP in another...etc. You really don't just choose one or the other.

In the case of the OP's questions, though, ethical questions often don't have a true right or wrong answer because they have unbelievable stipulations. For instance, if your house were burning down and you could only save your wife or child, which would you save? In the real world you would probably try to save both, but the question doesn't allow you to do that. I think it's important to acknowledge the possible consquences of each choice, to show that you fully understand the ramifications, and then choose an answer based on your gut instincts. I really think they want to know more about your thought processes than which choice you would really make.

 

[Bacchus]

My whole post was spawned about a discussion we had in Death and Dying today, we talked about how triage stemmed from the military.

 

[ronicajay]

Also, don't worry too much. Out of 5 interviews I had 1 ethical question, and it was phrased as a kind of joke...the situation presented to me was completely non-serious. You may come across the occasional tough interviewer, but it is rare I think. If you are posed with these types of questions, I agree with what previous posters said. Be calm and answer as rationally as you can.

 

[Bacchus]

I had policy/political questions at VCOM. But, it was not the monotonous task to answer them as perpetuated on SDN.

 

[scpod]

My whole post was spawned about a discussion we had in Death and Dying today, we talked about how triage stemmed from the military.

Well... the military model makes perfect sense in the middle of combat. hy would you spend hours trying to help someone who is probably dying when you could fix up a bunch of walking wounded and get them back out into battle. Of course, yu don't have to worry about being sued by the relatives because you didn't do every thing you could have to save grandad.

In this country you are pretty much expected to keep people alive as long as possible, no matter what the expense is or the ability to pay. It's one of the reasons why healthcare expenditures per capita are so much greater here in the US than anywhere else, but so many people still don't have access. Case in point: the other night a woman drives her mother into the ED entrance and mom's not breathing. She's 72 years old and weighs 70 lbs. She's tried to kill herself in the past because she was so miserable with living. Now she can't even communicate and daughter is the healthcare surrogate demanding we do everything possible. We spend thousands getting a pulse back, but she's on a vent and now using up ICU bed space and getting thousands in care every day. Yet, she'll never recover and never even speak again. This doesn't happen in most other places. They let them die in peace and spend the bucks on making other people well. Wow, did this turn into a rant, or what? Sorry.... back to regular programing. 😳

 

[Chocolate Bear]

Well... the military model makes perfect sense in the middle of combat. hy would you spend hours trying to help someone who is probably dying when you could fix up a bunch of walking wounded and get them back out into battle. Of course, yu don't have to worry about being sued by the relatives because you didn't do every thing you could have to save grandad.

In this country you are pretty much expected to keep people alive as long as possible, no matter what the expense is or the ability to pay. It's one of the reasons why healthcare expenditures per capita are so much greater here in the US than anywhere else, but so many people still don't have access. Case in point: the other night a woman drives her mother into the ED entrance and mom's not breathing. She's 72 years old and weighs 70 lbs. She's tried to kill herself in the past because she was so miserable with living. Now she can't even communicate and daughter is the healthcare surrogate demanding we do everything possible. We spend thousands getting a pulse back, but she's on a vent and now using up ICU bed space and getting thousands in care every day. Yet, she'll never recover and never even speak again. This doesn't happen in most other places. They let them die in peace and spend the bucks on making other people well. Wow, did this turn into a rant, or what? Sorry.... back to regular programing. 😳

Rant or not, this is one of the most irritating things about this country's obsession with political correctness/doing the right thing/guilt-driven policies/whatever you want to call it. It extends from the daughter's need to feel like she's not responsible for the death of her mother (??!!) to the doctors and hospitals that have to allocate precious resources on someone who can't be saved. And even if she can be saved, she doesn't want to be!! Gah!!

We have almost no right to die, and it makes me sick. Everyone should have a living will, and we need to seriously re-evaluate the way we handle end of life care.

Speaking of such, if you do get an ethical question, there's a decent shot it will cover this exact topic.

 

[DrMattOglesby]

i think what will help you most during questions like this is that no life is more valuable than another life.
sounds cheesy, but it is pertinent in situations where you have a drug overdose AND a heart attack patient coming in at the same time. We are not licensed to decide whose life is more valuable.

 

[DrMidlife]

UWash has a bioethics site that is EXCELLENT prep for interviews. Highly recommended: http://depts.washington.edu/bioethx/topics/index.html

 

[deleted172531]

UWash has a bioethics site that is EXCELLENT prep for interviews. Highly recommended: http://depts.washington.edu/bioethx/topics/index.html

Interesting stuff. Thanks for posting.👍

 

[cars321]

thanks for the responses.

i think what will help you most during questions like this is that no life is more valuable than another life.
sounds cheesy, but it is pertinent in situations where you have a drug overdose AND a heart attack patient coming in at the same time. We are not licensed to decide whose life is more valuable.

I agree with this. We are licensed to serve and give the best care possible. We cannot choose whose life is more valuable or whose life to save. We should try to the best of our abilities to help both.