Ethics in Medicine

[blackbird03]

I will be interviewing soon and I was wondering how you guys prepared for possible ethics questions. There seems to be an infinite number of cases that one can possibly ask. (e.g. ranging from abortion to physician assisted suicide etc...)

It would be awesome to start a discussion on ethics, just as we have for universal health coverage.

I will start the discussion with a simple question:

Do you know if there is a technique to approach these kinds of ethical dilemmas?

ER doctors often have to come up with answers to such complicated questions very quickly.

(For instance, what would a ER doc do if a trauma patient with terminal illness that comes in with very detailed and signed advanced directives asking not to be treated.)

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[Tweetie_bird]

There is nothing you can do.
The person has specifically asked you to not give any care. Giving it, would mean you are assaulting the patient against his wishes and you will be liable for your actions.

On the other hand, being a healer, you want to help in some way. I would check the Ad. Dir. Does the preson not want to be treated AT ALL?? Does the person not want to be on the ventilator? Or does the person have an Ad. Dir. saying "treat me but only for X amount of time. If I have been on the ventilator for X amount of time, take me off of it because I don't want to be on it for that long." That is the first thing I'd do.


So, if the person was just a DNR, I would give every kind of care possible except putting them on the vent. This includes taking care of their wounds/fractures/lacerations whatever problems they may have. I would give O2 to them.

If the AD. Dir said "don't treat me AT ALL," I would provide the patient some comfort care until the person passed away. this might include O2. Warm blankets to make them more comfortable. Probably contact their family members to authenticate the Ad. Dir. to me and inform them about the patient's decision in case they did not already know it.

Sad scenario. When people come into an ER all you wanna do is help but we do need to realize our own limitations. What may be "help" from our side may turn into an assault/insult to the patient's integrity if we push our boundaries.