Ethical Questions

[BluesClues32]

I've already looked at the interview feedback for several schools, but can anyone/everyone post any ethical questions they have been asked at interviews? I know about the 14 y/o birth control question. Any others? Thanks!

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[daveyjwin]

there's the "Old man vs Young Woman and Only One Respirator" question.

I didn't have it personally, but I've heard of it many times.

 

[Captain Fantastic]

Just some ideas for you...

• Would you perform abortions as a doctor? Under what conditions?
• If there was an accident on the highway, would you stop and help the victims, knowing that doing so might lead to a malpractice claim against you?
• What do you think about euthanasia? What about physician assisted suicide?
• What do you think about alternative medicine?
• What would you do if someone in your PBL group wasn't contributing?
• Do you support either population cloning or parts cloning?

 

[RD330]

I was asked these:

1. You're a family pract. for the past 10 years for this family. The daughter that you've watched grow up from 8 to 18 has come to you asking for advice. She has had unprotected sex and has missed her period. She is wanting to have an abortion....what do you do?

2. You're the only ER doc in a rural town and you have three traumatic patients come in at once. A man in respiratory arrest; a man with severe chest pain; and a woman in the middle of labor.

3. You're a transplant surgeon. You have 3 men lined up that all need a heart. You only have one heart. They all have identical histories and they all have families. One is a doctor, one is a factory owner that employees over a thousand workers, and one is a milkman. Who gets the heart?

4. In a hospital, you have nurses, doctors, techs, janitors, secretaries, etc... Who is the most important and why?


The man who was interviewing me knew that these questions were extreme. And told me that he was just curious as to what I was going to say. And after the ER guestion we both kind of laughed and kept going. In other words, he was not being a hardball about it.

 

[ExtraAverage]

I've already looked at the interview feedback for several schools, but can anyone/everyone post any ethical questions they have been asked at interviews? I know about the 14 y/o birth control question. Any others? Thanks!

How bout this one:

"If there was a massive plague that killed everyone off and you and Phyllis Diller were the last two people on the face of the earth, would you have sexual intercourse to save the human race?"

 

[laboholic]

3. You're a transplant surgeon. You have 3 men lined up that all need a heart. You only have one heart. They all have identical histories and they all have families. One is a doctor, one is a factory owner that employees over a thousand workers, and one is a milkman. Who gets the heart?

This is an interesting question and I have seen variations of it many times on SDN. Obviously, social status should not be an issue when deciding who gets a life-saving procedure. But, in real life there would never be 3 identical candidates... one will always be the best choice. Nonetheless, the question always seems to state that the 3 people are identical in their histories. So... what do you say to that? Flip a three sided coin? I hope I dont get asked that.

 

[turnerm37]

UNOS has priority lists for transplantation...the organ is given to the next matched candidate on the list. There are other criteria/rules that dictate where the organ goes instate/outstate etc. I don't know the specifics but there are rules. You would act accordingly.

 

[RD330]

This is an interesting question and I have seen variations of it many times on SDN. Obviously, social status should not be an issue when deciding who gets a life-saving procedure. But, in real life there would never be 3 identical candidates... one will always be the best choice. Nonetheless, the question always seems to state that the 3 people are identical in their histories. So... what do you say to that? Flip a three sided coin? I hope I dont get asked that.

I thought it was a pretty outragious situation, BUT he wanted me to answer it while he held a smirk on his face. (he was totally nice about it though) So, I had to make a small joke b/c i thought it was funny that he said "milkman." My father-in-law was in fact a milkman for a little while and I told him i was partial to them b/c of that! He laughed and that also gave me time to think. So then I said the factory worker NOT getting the heart would have the most effect on society (since he employeed so many people.) So, that's who I said should get the heart. He seemed happy with my answer and I think his main point was to make sure I was willing to give an answer and not just freak out saying "I DON'T KNOW!!"

Oh yea..I forgot to add that at the end he asked me "how do you feel that the other two men died b/c of your decision?" GEEZ. He told me later that his point was to make sure that I realize that being a doctor does not always mean helping people....people are going to die in your hands and do you have the ability to handle that.

 

[laboholic]

UNOS has priority lists for transplantation...the organ is given to the next matched candidate on the list. There are other criteria/rules that dictate where the organ goes instate/outstate etc. I don't know the specifics but there are rules. You would act accordingly.

what if all three people are the exact same number on the waiting list, then what??

Ha Ha, just kidding

 

[drjds]

Just some ideas for you...

• Would you perform abortions as a doctor? Under what conditions?
• If there was an accident on the highway, would you stop and help the victims, knowing that doing so might lead to a malpractice claim against you?
• What do you think about euthanasia? What about physician assisted suicide?
• What do you think about alternative medicine?
• What would you do if someone in your PBL group wasn't contributing?
• Do you support either population cloning or parts cloning?

Can you give me an idea of how you would answer these questions?

 

[notnarcsDO]

Can you give me an idea of how you would answer these questions?

As for number two, if you are a certified healthcare professional (or even a lifeguard with CPR training for that matter), arent you required by law to stop and help them, and if you are caught not doing so, you are considered negligent?

 

[DrMom]

I'm moving this to the new topics in healthcare forum...

 

[bananaface]

I got asked the one about the non-contributing group member. Ideally, you would talk to them to see if something else is going on in their life, at least according to my school's adcom. Case and point, I have a professor who has been late grading papers for the past few weeks. It turns out that she was just diagnosed with breast cancer and was spending alot of time on testing and treatment.

This question may very well have been the one that made me a re-applicant. In my interview, I was all for kicking them out of the group and making them do something on their own. I still have issues with people getting credit for work they don't do. I learned alot in the extra year off, though.

 

[Lests55]

Those are some tough questions. I got some stuff like that while applying for a BS/MD (didn't get in, guess I need to work on that! )

 

[DrBowtie]

As for number two, if you are a certified healthcare professional (or even a lifeguard with CPR training for that matter), arent you required by law to stop and help them, and if you are caught not doing so, you are considered negligent?

Im pretty sure negligence only occurs when it is your job or you begin treatment.

 

[Redneck]

Here is a website that is very informative with medical ethics. Check it out.

http://depts.washington.edu/bioethx/topics/index.html

 

[Miss155]

I was asked these:

1. You're a family pract. for the past 10 years for this family. The daughter that you've watched grow up from 8 to 18 has come to you asking for advice. She has had unprotected sex and has missed her period. She is wanting to have an abortion....what do you do?

2. You're the only ER doc in a rural town and you have three traumatic patients come in at once. A man in respiratory arrest; a man with severe chest pain; and a woman in the middle of labor.

3. You're a transplant surgeon. You have 3 men lined up that all need a heart. You only have one heart. They all have identical histories and they all have families. One is a doctor, one is a factory owner that employees over a thousand workers, and one is a milkman. Who gets the heart?

4. In a hospital, you have nurses, doctors, techs, janitors, secretaries, etc... Who is the most important and why?


The man who was interviewing me knew that these questions were extreme. And told me that he was just curious as to what I was going to say. And after the ER guestion we both kind of laughed and kept going. In other words, he was not being a hardball about it.

I had the exact same questions at TCOM

 

[bananaface]

Here is a website that is very informative with medical ethics. Check it out.

http://depts.washington.edu/bioethx/topics/index.html

Nice link!

 

[QuikClot]

Just some ideas for you...

• Would you perform abortions as a doctor? Under what conditions?
• Do you support either population cloning or parts cloning?

I would perform abortions only in cases where the mother agrees to a tissue biopsy of the fetus, allowing future generations to clone him/her.

• If there was an accident on the highway, would you stop and help the victims, knowing that doing so might lead to a malpractice claim against you?
• What do you think about euthanasia? What about physician assisted suicide?

I support euthanasia of all malpratice lawyers.

• What do you think about alternative medicine?
• What would you do if someone in your PBL group wasn't contributing?

If someone wasn't contributing, I would simply re-align their chakras with my healing crystals.

 

[Captain Fantastic]

As for number two, if you are a certified healthcare professional (or even a lifeguard with CPR training for that matter), arent you required by law to stop and help them, and if you are caught not doing so, you are considered negligent?

In my state, the legal "duty to act" hinges on whether you are on duty or not. You are not legally required to stop and help if you are off duty (although I believe you have a moral obligation to help). If you do stop and help, you assume all the responsibilities just as if you were on duty and responded. (For example, you must stay with the patient until you hand him/her of to someone with an equal or greater licensure -- otherwise it's abandonment). My state also has a "Good Samaritan" law on the book: if you are off duty and stop to help you are protected from civil suit, so long as you practice with in your licensure (Lifeguard's had better not try to surgically open an airway, etc.).

This varies from state to state, though.

 

[Hoberto]

For most of these questions I would just answer that I would do whatever the legal statutes of my state and employer dictated.

I did get asked, "What do you think about people who read spiritual stories to help them get them through tough times?"

 

[Zoom-Zoom]

I did get asked, "What do you think about people who read spiritual stories to help them get them through tough times?"

Stories? Like...the Bible?


I don't get the young kid abortion question. Is there something dangerous about giving abortions that makes younger people more controversial? To be honest, I think we should encourage people under 18 to get abortions...

 

[QuikClot]

I was asked these:

1. You're a family pract. for the past 10 years for this family. The daughter that you've watched grow up from 8 to 18 has come to you asking for advice. She has had unprotected sex and has missed her period. She is wanting to have an abortion....what do you do?

I need more information. Is she hot? Is it mine?

3. You're a transplant surgeon. You have 3 men lined up that all need a heart. You only have one heart. They all have identical histories and they all have families. One is a doctor, one is a factory owner that employees over a thousand workers, and one is a milkman. Who gets the heart?

[Removing jester cap] Their professions are absolutely irrelevant. It is not my function as a doctor to determine the social utility of a life. If I admit that into my decision-making process, I am assuming the right to evaluate the worth of a life, and who is the better person. Non, non, non!

Society may make decisions like that -- in fact, whenever we deny access to healthcare on the basis of the ability to pay, society does make decisions like that. But individual healthcare providers have no right to do so. If I have no medically useful information, I would give the heart to whomever had been waiting longest, or randomly -- under no circumstances am I going to assign medical resources based on my assessment of how moral, intelligent, talented or useful a person is.

 

[QuikClot]

[Putting cap back on] On second thought, give it to the doctor -- he's going to owe me a lifetime of referrals.

 

[Beau Geste]

I've already looked at the interview feedback for several schools, but can anyone/everyone post any ethical questions they have been asked at interviews? I know about the 14 y/o birth control question. Any others? Thanks!

You realize there are 2 answers to the 14 y/o question don't you....

 

[Beau Geste]

Just some ideas for you...

• Would you perform abortions as a doctor? Under what conditions?

• 
  
  No. I would refer to another doctor if that's what they needed. I'm not a doctor so I'm not sure about what specialty I'll be in and if there are any special cases to consider at this time.
  

  [*]If there was an accident on the highway, would you stop and help the victims, knowing that doing so might lead to a malpractice claim against you?

  No, I'm not a Dr. yet. If I was a Dr. I would probably help if I was the 1st one on the scene. If there is a paramedic there, then probably not.
  

  [*]What do you think about euthanasia? What about physician assisted suicide?

  They are both against the law
  

  [*]What do you think about alternative medicine?

  Given a reputable source, it could be beneficial
  

  [*]What would you do if someone in your PBL group wasn't contributing?

  Have a serious chat with them. If no improvement, switch groups or have them switched, or talk with the professor.
  

  [*]Do you support either population cloning or parts cloning?

Parts cloning maybe. I don't know enough about cloning. Population cloning - no.

 

[Beau Geste]

I was asked these:

1. You're a family pract. for the past 10 years for this family. The daughter that you've watched grow up from 8 to 18 has come to you asking for advice. She has had unprotected sex and has missed her period. She is wanting to have an abortion....what do you do?

First I would do a pregnancy test. If positive, then I would talk to her about her options. She's 18 and a legal adult. As a family friend you could try to encourage adoption, but in the end, it's her choice. I would definitely also have her get checked for STDs and counsel her on birth control, and maybe for psychological counseling if she was really distraught. Talking to her family is a big no-no.

2. You're the only ER doc in a rural town and you have three traumatic patients come in at once. A man in respiratory arrest; a man with severe chest pain; and a woman in the middle of labor.

Give the man with chest pain an aspirin (or similar) and have a nurse hook him up to monitors or do a stress test if not too severe, send the woman to OB with a nurse and call her OBGYN, and attend to the man in respiratory arrest.

I could be totally wrong for my choices, but that's what med school is for.

3. You're a transplant surgeon. You have 3 men lined up that all need a heart. You only have one heart. They all have identical histories and they all have families. One is a doctor, one is a factory owner that employees over a thousand workers, and one is a milkman. Who gets the heart?

Who's higher on the list? What is the hospital policy?

4. In a hospital, you have nurses, doctors, techs, janitors, secretaries, etc... Who is the most important and why?

No one is the most important - they all have important jobs. Nurses provide admitting and follow-up care, doctors make treatment decisions and perform procedures, techs follow orders for technical procedures, janitors keep the place clean and free from infection (a very important thing), secretaries help with scheduling and organization, etc, etc. The hospital should function as a unit with no one more important than the other.

That doesn't mean a doctor has a less hard job, but there is importance in everyone.

 

[HenryOR]

PAS is very legal in Oregon and Washington! And probably more states to come..

 

[cpants]

pas is very legal in oregon and washington! And probably more states to come..

wtf?

 

[FutureCTDoc]

In my state, the legal "duty to act" hinges on whether you are on duty or not. You are not legally required to stop and help if you are off duty (although I believe you have a moral obligation to help). If you do stop and help, you assume all the responsibilities just as if you were on duty and responded. (For example, you must stay with the patient until you hand him/her of to someone with an equal or greater licensure -- otherwise it's abandonment). My state also has a "Good Samaritan" law on the book: if you are off duty and stop to help you are protected from civil suit, so long as you practice with in your licensure (Lifeguard's had better not try to surgically open an airway, etc.).

This varies from state to state, though.

Duty to rescue is seldom a legally binding concept see Buch v. Armory Mfg Co. Emergency workers, parents as well as in loco parentis, spouses, common carriers, employers via implied contract have these requirements. It is also law, although commonly disregarded in Fl, MA, MN, OH, RI, VT, WA and WI. However legally it is questionable. Also see Yania V. Bigan
http://law.missouri.edu/peters/t2syllabus.html
Good discussion of this
http://www.scribd.com/doc/2465135/Yania-v-Bigan
Case law
http://philosophy.wisc.edu/hunt/duty2res.htm
Discussion of the morals of the issue

 

[thedrjojo]

First I would do a pregnancy test. If positive, then I would talk to her about her options. She's 18 and a legal adult. As a family friend you could try to encourage adoption, but in the end, it's her choice. I would definitely also have her get checked for STDs and counsel her on birth control, and maybe for psychological counseling if she was really distraught. Talking to her family is a big no-no.

Why do you have to encourage adoption? That is taking a paternalistic approach to medicine and imposing your personal views over sound medical practice. Talking about options is legit... not performing abortions yourself is legit, but I don't understand this necessity to push your views... if the patient asks: "hey doc, what would you do", or asked for your recommendation, then you can do state that, but otherwise... if a patient comes in pregnant and wants to keep the child, no doctor would ever encourage adoption/abortion, and same thing, if a patient comes in pregnant and wants to do adoption, no doctor ever encourages abortion, so why only in this situation do the wholier than thou anti-choice side feel the need to impose their opinion.

Give the man with chest pain an aspirin (or similar) and have a nurse hook him up to monitors or do a stress test if not too severe, send the woman to OB with a nurse and call her OBGYN, and attend to the man in respiratory arrest.

I could be totally wrong for my choices, but that's what med school is for.

The point is that these are all situations that need immediate attention, so what is your priority and how can you justify them. It also assumes that obgyn isn't available at the time... There is no right or wrong choice, and I personally (and just finished ACLS training today) would attend to the respiratory arrest because he is the most severe at the moment (chest pain, the goal is 90 minutes door to balloon, labor, people deliver unattended all the time, respiratory arrest you have to start a code asap so not really a bit question IMHO)

Who's higher on the list? What is the hospital policy?



No one is the most important - they all have important jobs. Nurses provide admitting and follow-up care, doctors make treatment decisions and perform procedures, techs follow orders for technical procedures, janitors keep the place clean and free from infection (a very important thing), secretaries help with scheduling and organization, etc, etc. The hospital should function as a unit with no one more important than the other.

That doesn't mean a doctor has a less hard job, but there is importance in everyone.

Again, this is a cop out answer, and probably one they hear 9 times outa 10. These questions don't have right answers... or the "right" answer probably depends on who asks the question. But be prepared to have them say... "I know everyone is important, but that's not what I asked... who do you think is the most important?" And they might not be looking for you to say Doctor either (but they might also respect you being honest)

 

[ceasefire]

How bout this one:

"If there was a massive plague that killed everyone off and you and Phyllis Diller were the last two people on the face of the earth, would you have sexual intercourse to save the human race?"

She's post-menopausal, so knowing there's no chance of conceiving I would gladly say no.

 

[princealbert16]

Just some ideas for you...

• Would you perform abortions as a doctor? Under what conditions?
• If there was an accident on the highway, would you stop and help the victims, knowing that doing so might lead to a malpractice claim against you?
• What do you think about euthanasia? What about physician assisted suicide?
• What do you think about alternative medicine?
• What would you do if someone in your PBL group wasn't contributing?
• Do you support either population cloning or parts cloning?

How would you answer the second question about the accident on the freeway today? (I'm trying to prepare for interviews rn) Thank You!