Ethical questions

[LuciusVorenus]

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So I'm trying to create a list of ethical questions that we've discussed on here so that I can try and do something useful with it later on for those of us that are interviewing, and so far I've found these:

"What would you do if a patient asked you to perform an abortion and you are morally against it?"
"What would you do if you see your good friend cheating?"
“A patient spends $800 a month on prescription drugs. This patient decided to drive to Canada for her drugs and get the prescription filled and then drive back. It was half the cost there, but what she does is illegal. What would you do as her doctor?”
“A trolley is running towards five people who will be killed if it proceeds on its present course. The only way to save them is to pull a lever that will divert the trolley to a side track. On the side track stand one person who will be killed.”
“Two patients are in a nursing home, long-time residents. Male: 82-years-old. Female: 70-years-old. Both have marked dementia and are single but are often seen together and holding hands. One day, a visitor comes in, catches the two patients in coitus, and calls nurses immediately to separate them. A report is filed. Separate them to different floors or let it continue? Why?”
“What you would do if you're working with a surgeon, and you smell alcohol on his breath?”


If you know of anymore, please add them! 😀

 

[Compass]

Questions that don't ask black and white are MUCH more difficult to answer. This one I thought up while being morally bored yesterday.

You have 100 cures and 200 patients.
100 of the patients are 70 years old. The vaccine is 100% effective for them. However, they are all expected to die within 10 years.
The other 100 patients are 10 years old The cure is only 30% effective, meaning they have a 30% chance of dying even given the cure. However, given the cure, the life expectancy of the children is 70 more years IF they survive.




If anyone can mathematically solve this problem, amaze me. Otherwise, use morals, please.

 

[johndoe3344]

Questions that don't ask black and white are MUCH more difficult to answer. This one I thought up while being morally bored yesterday.

You have 100 cures and 200 patients.
100 of the patients are 70 years old. The vaccine is 100% effective for them. However, they are all expected to die within 10 years.
The other 100 patients are 10 years old The cure is only 30% effective, meaning they have a 30% chance of dying even given the cure. However, given the cure, the life expectancy of the children is 70 more years IF they survive.




If anyone can mathematically solve this problem, amaze me. Otherwise, use morals, please.

This question is silly. The expected life-years gained from treating an old person is 10. The expected life-years gained from treating a child is 0.3*70=21. We use all 100 cures to save the children.

EDIT: To not derail the thread, I came across some:

1) You are the editor for a journal for <insert favorite medical school>. You have an assignment due tomorrow, but you also have a microbiology test tomorrow that you completely forgot about. You can only do one thing. Which do you do, and why?

2) One Sunday afternoon in your first year of medical school you are studying for your biochemistry test. This is your fourth out of five tests and you can flunk this test and still pass the course. A group of very good friends calls and tells you that they will be in town only for tonight and they want you to spend the evening out with them. What do you do and why?

 

[Compass]

This question is silly. The expected life-years gained from treating an old person is 10. The expected life-years gained from treating a child is 0.3*70=21. We use all 100 cures to save the children.

So you would prefer to save POSSIBLY 30 children than to save DEFINITELY 100 old people?

 

[EyEnStein 07]

So you would prefer to save POSSIBLY 30 children than to save DEFINITELY 100 old people?

I assume there are "great answers"..."good answers"..and "ok answers"...i just dont see something that different in that question.

were talking about 100 old people for 10 years v.s (probability wise) 70 people for 70 years...i would go with the latter though...

also...isnt it 70 not 30? 30% effective meaning that there is a 70% chance of survival?

 

[LuciusVorenus]

So you would prefer to save POSSIBLY 30 children than to save DEFINITELY 100 old people?

Equal opportunity providers.
I'd save the old people.

 

[Compass]

I assume there are "great answers"..."good answers"..and "ok answers"...i just dont see something that different in that question.

were talking about 100 old people for 10 years v.s (probability wise) 70 people for 70 years...i would go with the latter though...

also...isnt it 70 not 30? 30% effective meaning that there is a 70% chance of survival?

Oops, I meant the other way in my writing. 30% effective, 70% dying. You can save 30 kids, 100 oldies, or a mix of the two, basically. Tweaking the percentage up or down along with the age creates an interesting effect as well. 10% and 70 years versus 10 years guaranteed for the old people.

Even scarier is when you tweak the survival time of the peds down lower as well. The question digs into your emotions rather than your ethics moreso than other questions, I think.

 

[LuciusVorenus]

Oops, I meant the other way in my writing. 30% effective, 70% dying. You can save 30 kids, 100 oldies, or a mix of the two, basically. Tweaking the percentage up or down along with the age creates an interesting effect as well. 10% and 70 years versus 10 years guaranteed for the old people.

Even scarier is when you tweak the survival time of the peds down lower as well. The question digs into your emotions rather than your ethics moreso than other questions, I think.

I know what you mean
if there was an accident and there were 2 people lying on the pavement, one who was 40 and had a 60% chance of survival and one who was 10 and had a 20% chance of survival, I really don't know what I would do.

 

[LuciusVorenus]

I'm not shamelessly bumping, promise.
Just need to keep these for later here
😛

"Person is of sound mind, but can't move at all. Wishes to starve to death in at a nursing home. Allow or not?"

 

[Compass]

I know what you mean
if there was an accident and there were 2 people lying on the pavement, one who was 40 and had a 60% chance of survival and one who was 10 and had a 20% chance of survival, I really don't know what I would do.

I wouldn't either, because I'd be too worried wondering how I predicted those chances of survivals! Call 911!

 

[TopSecret]

Oops, I meant the other way in my writing. 30% effective, 70% dying. You can save 30 kids, 100 oldies, or a mix of the two, basically. Tweaking the percentage up or down along with the age creates an interesting effect as well. 10% and 70 years versus 10 years guaranteed for the old people.

Even scarier is when you tweak the survival time of the peds down lower as well. The question digs into your emotions rather than your ethics moreso than other questions, I think.

The number of years "saved" should be equal in both groups if we want to be fair to both the elderly and the young.

So to set up the equation...

Years saved for the old = Years saved for the young
x = vaccines for the old
100 - x = vaccines for the young

(10 years)(1.00)x = (70 years)(0.30)(100 - x)
10x = 21(100 - x)
10x = 2100 - 21x
31x = 2100
x = 67.74 or 68 rounding up

The old group receives 68 vaccines and the young group receives 32 vaccines to keep the years saved equal.

The vaccines should then be distributed based on a lottery draw for both groups.

The number of lives saved is then 68 for the elderly and about 10 for the kids.

 

[TopSecret]

Alternatively...

Lives saved for the old = Lives saved for the young
x = vaccines for the old
(100 - x) = vaccines for the young

x = .3(100 - x)
x = 30 - 0.3x
1.3x = 30
x= 23

Save 23 old patients and 23 young patients using 23 vaccines for the old and 77 vaccines for the young.

The vaccines should also be distributed by a lottery draw among both groups.

 

[RogueUnicorn]

I know what you mean
if there was an accident and there were 2 people lying on the pavement, one who was 40 and had a 60% chance of survival and one who was 10 and had a 20% chance of survival, I really don't know what I would do.

if it were a well equipped hospital under normal circumstances, treat the 20% first. if you were the first responder with no help to come, use the disaster triage principle and go with the one with higher survival chance. age is not really a factor here, though it is tough emotionally

 

[TopSecret]

I know what you mean
if there was an accident and there were 2 people lying on the pavement, one who was 40 and had a 60% chance of survival and one who was 10 and had a 20% chance of survival, I really don't know what I would do.

If the life expectancy for the 40 year-old is another 40 and for the 10 year-old it's another 70, then it's probably better to work on the 40 year-old because of the higher chance of survival with treatment and a greater number of years saved.

40 x 0.6 = 24
70 x 0.2 = 14

24 > 14

 

[TopSecret]

If anyone can mathematically solve this problem, amaze me. Otherwise, use morals, please.

I solved the problem mathematically. Are you amazed yet? 😎

 

[TopSecret]

You can also use a lottery draw.

About 50 old patients and 15 young patients would be saved in this manner.

 

[LuciusVorenus]

I solved the problem mathematically. Are you amazed yet? 😎

 

[TopSecret]

I got a perfect score on the math part of the college boards and also got a superior score on the military intelligence test.

Go me. 😎

 

[LuciusVorenus]

I got a perfect score on the math part of the college boards and also got a superior score on the military intelligence test.

Go me. 😎

Can I ask what your specialty is