ethics interview questions

[Guile]

I agree with the above post. If your heart bleeds that much over $75 it would be better to pay it yourself rather than commit insurance fraud. Also, doctors must bill charges for services rendered...but they do have the option of writing off unpaid bills as well. Look, if we were talking about a $10,000 surgery it would be one thing, but we're talking about the kind of money you can make anywhere...sell your TV in the newspaper, donate plasma, pull an extra shift, sell some old items on Ebay using library computer/Internet access, etc. You can't tell me that any American can't find a way to scrounge up $75 for a once-a-year expense. Just because someone doesn't want to give up their new 22's to do it doesn't mean they can't afford healthcare- it also doesn't mean that doctors should commit insurance fraud for their unwillingness to make personal sacrifices. Afterall, shouldn't our health be the first priority when it comes to money management?

You make some good points here. I was talking with a resident the other day who told me about a study that looked at the number of people who actually CAN'T AFFORD healthcare vs. the number of people who could afford and would just rather spend their money on 22's and other depreciating goods. You can't just look at the number of people who don't have insurance because what if they choose not to pay for it so they can get a bigger cut of their paycheck? So just don't let your bleeding hearts bleed too much for EVERYONE without insurance...

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[LizzyM]

I agree with the above post. If your heart bleeds that much over $75 it would be better to pay it yourself rather than commit insurance fraud. Also, doctors must bill charges for services rendered...but they do have the option of writing off unpaid bills as well.

Insurance companies are now looking to see what proportion of bills are paid in full. They don't want to pay 80% of a $100 tab and discover that the doctor was willing to take $80 rather than the full $100. Next thing you know, they tell you that they will only pay $64 (80% of $80 ). You'll also get dinged if you charge the insurance company X but give the same service to uninsured patients at no charge (taking the $75 from your own pocket, so to speak).

Suffice to say that questions of honesty in insurance and record keeping is a topic for ethics questions.

 

[Guile]

2.) Over the counter emergency contraception/morning after pill?

Not really an issue anymore since it's now OTC.

 

[LizzyM]

Not really an issue anymore since it's now OTC.

The question would be would you prescribe it to a teen (for some people it is the moral equivalent of abortion). Put a more interesting twist on it; what if the patient is 14 years old and the person bringing her to you is an older man who is her sexual partner?

 

[63768]

Suffice to say that questions of honesty in insurance and record keeping is a topic for ethics questions.

so in your opinion, what is a good response to the insurance fraud question? committing fraud is dishonest but helps a patient who would benefit from it. i can't see how you would rationalize it without being a bad person.

The question would be would you prescribe it to a teen (for some people it is the moral equivalent of abortion). Put a more interesting twist on it; what if the patient is 14 years old and the person bringing her to you is an older man who is her sexual partner?

oh man that would screw me up at first. but i think doctors have a mandate to report sexual abuse/abuse with their peds patients, so i don't see the wrong in reporting this guy.

 

[kypdurron5]

Not really an issue anymore since it's now OTC.

True, but the information I read most recently stated that the OTC "Plan-B" is not the same thing as the "Abortion Pill" that's also been in the news. Appearantly Plan B only prevents implantation but does not cause menstruation to occur...thus if an embryo has already implanted it will do nothing. The Abortion Pill caused an immediate menstruation that would abort an embryo even if it had already implanted. It's a subtle difference...but it is a little bit of a compromise between preventing fertilization and actually causing the "abortion" of an implanted fetus. Is it still abortion?.......::

 

[asunshine]

Insurance companies are now looking to see what proportion of bills are paid in full. They don't want to pay 80% of a $100 tab and discover that the doctor was willing to take $80 rather than the full $100. Next thing you know, they tell you that they will only pay $64 (80% of $80 ). You'll also get dinged if you charge the insurance company X but give the same service to uninsured patients at no charge (taking the $75 from your own pocket, so to speak).

Suffice to say that questions of honesty in insurance and record keeping is a topic for ethics questions.

and once you do it once, word gets around and everyone will expect the same from you. and the patient will expect the same the next time, and the next.... plus, you will most likely be a member of a group practice and they will NOT like that you're forfeiting their revenue, too.

that said, if i could do it my way, i'd just write it off for a patient that i knew well and that i knew needed it, as long as the rules were clear (this is a one-time thing, i trust that you will not tell other patients in the waiting room, and so on).

nothing's foolproof, but is the point of medicine to serve those in need, or to make money?

 

[Guile]

The question would be would you prescribe it to a teen (for some people it is the moral equivalent of abortion). Put a more interesting twist on it; what if the patient is 14 years old and the person bringing her to you is an older man who is her sexual partner?

Now that's a good interview question--one I hope I don't get. And a situation I hope I never have to face. But I wouldn't have any problem busting some middle-aged wacko who's having sex with a 14-year-old.

 

[kypdurron5]

but is the point of medicine to serve those in need, or to make money?

Clearly the answer is both. Becoming a physician is not just about helping other people, it's also about choosing a profession that will allow you to make a living as well.

 

[LizzyM]

so in your opinion, what is a good response to the insurance fraud question? committing fraud is dishonest but helps a patient who would benefit from it. i can't see how you would rationalize it without being a bad person.

oh man that would screw me up at first. but i think doctors have a mandate to report sexual abuse/abuse with their peds patients, so i don't see the wrong in reporting this guy.

You've got to work this out in your own mind. Another one that has come up (in real life) is when a pateint's relative calls & leaves a message asking you to write a letter to an airline so that they can change a flight with no penalty "because of a severe illness" when, in truth, the patient isn't really that sick. And the person asking isn't poor, but very rich and a very big donor to the hospital. (They didn't get rich by letting the money slip through their fingers.) It isn't insurance fraud and the guy's aged mom is in the hospital; all you have to do is make it sound serious and fax the letter to the airline.

 

[asunshine]

on another note, what about the parents who don't want you to tell the kid he/she is dying? let's say a school-age child. i talked to someone today who thought that parents (legally) have every right to decide what is told to their child and what is not. is that true?

i think coming to terms with the dying process is important work for children, too. it would be hard for me to not tell a child, especially when asked. i think kids are stronger than adults sometimes. and they pick up on much more than we think anyway. any thoughts? i don't have much pediatric experience, so i'd love to hear from parents or former sick children

 

[LizzyM]

Clearly the answer is both. Becoming a physician is not just about helping other people, it's also about choosing a profession that will allow you to make a living as well.

And be honest in your dealings with others in society.

 

[Sol Rosenberg]

You've got to work this out in your own mind. Another one that has come up (in real life) is when a pateint's relative calls & leaves a message asking you to write a letter to an airline so that they can change a flight with no penalty "because of a severe illness" when, in truth, the patient isn't really that sick. And the person asking isn't poor, but very rich and a very big donor to the hospital. (They didn't get rich by letting the money slip through their fingers.) It isn't insurance fraud and the guy's aged mom is in the hospital; all you have to do is make it sound serious and fax the letter to the airline.

In your expereince, does this particular situation happen frequently, or are these just contrived examples with no "right" answer meant to stress out interviewees?

 

[Guile]

or are these just contrived examples with no "right" answer meant to stress out interviewees?

 

[asunshine]

Clearly the answer is both. Becoming a physician is not just about helping other people, it's also about choosing a profession that will allow you to make a living as well.

I agree with your other posts, but I disagree with you on this one. "Making a living" as a doctor is three times what the average household income is. Why can't a physician part with some money here and there? I'm not saying all the time, but when a legitimate good deed is asked of someone, they should rise to the occasion. $75 to a doctor may seem like $1000 to a poor patient.

 

[modelslashactor]

I wouldn't have any problem busting some middle-aged wacko who's having sex with a 14-year-old.

I don't know that any of us would, but does this violate the doctor-patient relationship?

 

[Guile]

I agree with your other posts, but I disagree with you on this one. "Making a living" as a doctor is three times what the average household income is. Why can't a physician part with some money here and there? I'm not saying all the time, but when a legitimate good deed is asked of someone, they should rise to the occasion. $75 to a doctor may seem like $1000 to a poor patient.

It's got to be up to individual doctor. If have a kind soul and don't mind comping part of patient's bills, then do that. I know I will. But if a doctor wants to charge everyone the full amount, that's his perogative. There are avenues for healthcare for those that truly cannot afford it. If you try to legislate this, then you get socialized healthcare. Good Lord, I don't want to get sick in a socialized healthcare country. Or need a bypass and have to wait 13 months.

But that's an argument for a different day in a different thread.

 

[Sol Rosenberg]

I don't know that any of us would, but does this violate the doctor-patient relationship?

The wacko isn't your patient in this contrived example. In another contrived example where he is, you have a duty as a CITIZEN that is perhaps equal to or greater than your duty as a doctor to report crimes to the authorities. Since there is no correct answer to this question, you could go either way and say that your duty as a doctor to preserve doctor-patient confidentiality is greater and you wouldn't turn in the wacko. You could also go the other way and say that your duty as a citizen is greater and you would turn in the wacko.

EDIT: A contrived example where the "wacko" is your patient is the good 'ol "You diagnose one of your patients with HIV. His wife is in the waiting room and wants to know what is going on. He asks you not to tell her what is wrong with him. What do you do?"

 

[Guile]

I don't know that any of us would, but does this violate the doctor-patient relationship?

I really don't know. There are so many laws regarding juveniles I'm just not sure. And they also vary by state. Some states require that the parents of underage girls must be notified of an abortion. In that case, I think they would find out pretty quickly who got her pregnant and justice would follow its course.

I know that as a physician you have to notify the authorities if you suspect child abuse. So I don't know why it would be different for sexual abuse/underage rape. (I know that adults have the option to press charges or not.) But I'm not sure about consensual statuatory rape. There are just so many variables.

Do we take a class on this in med school? Or maybe it's included in intern orientation after graduating?

 

[kypdurron5]

I agree with your other posts, but I disagree with you on this one. "Making a living" as a doctor is three times what the average household income is. Why can't a physician part with some money here and there? I'm not saying all the time, but when a legitimate good deed is asked of someone, they should rise to the occasion. $75 to a doctor may seem like $1000 to a poor patient.

Doctors do make concessions all the time... Just by contracting with insurance companies they loose tons of potential profits. I just had an annual physical last month...billed charges for visit plus labs were over $130, but actual insurance reimbursement was only around $30. I can't imagine that that a good 10-20 minute visit with a doctor, plus nurse services, and the actual cost of labs and supplies could be much less than $30. That's hardly any profit. Sure, doctors make more than average blue-collar workers, but they also have a shorter working life-span, begin with huge amounts of debt, dedicate at least 7 years beyond undergraduate studies just to the study of medicine, and pay more professional (esp. malpractice) fees than almost any other profession. The truth is that doctors deserve to make a "good" living, and I hardly ever use the word "deserve." Without this economic benefit the costs of medical school (in money, time, and difficulty) would simply not be worth it. My point is that if you've decided to become a doctor without any consideration to this cost/benefit structure then you've made a poor and uninformed decision.

Thus I feel that while doctors should be sensitive to the needs of their patients, doctors have earned the right to be paid for the services they provide. I also feel that doctors have a certain responsibility to provide services to those who cannot afford them, but this should not come at the cost of committing insurance fraud or doing anything else unethical. There may be an extremely small minority of Americans who truly cannot scrounge up $75 for a necessary health charge, but I agree with the other poster that those who are unwilling to scrounge up the money far outnumber those who are unable to do it.

 

[RokChalkJayhawk]

not to sound too girl or anything, but there have been like 3 episodes of grey's anatomy with these situations. it's good to keep up w/ your pop culture

Grey's Anatomy=Joke. Interns don't get the most interesting cases in the hospital. They get to do scut monkey stuff like Narc rounds.

If you questioned your attending like they do, your ass would get drummed out of the hospital. Also, even if you questioned your attending and you were correct, it would be once a year(if that frequent), not once an episode.

On your average floor, the DNRs are rarely that complicated. For dramatic effect, Grey's Anatomy makes em a bit more fancy.

Read the part in House of God when they continually try to save an unsalvalgable patient. Its actually kind of horrific.

 

[RokChalkJayhawk]

A good ethical question is something like "Do you try and save a patient's mangled leg or go ahead with the indicated amputation."

My Dad's a surgeon and one of his greatest regrets is trying to save a young guy's leg that should probably have been amputated, but his patient begged him to save it. 6 months and more than a dozen surgeries later, the leg was finally amputated. The guy went home a shell of his former self when he could have gone home in a couple days and started getting used to life with a prosthetic leg. His uality of life probably would have been pretty good too had he simply gone ahead with the amputation, who knows what 6 tormenting months did to this guy's psyche and overall health.

 

[kypdurron5]

A good ethical question is something like "Do you try and save a patient's mangled leg or go ahead with the indicated amputation."

My Dad's a surgeon and one of his greatest regrets is trying to save a young guy's leg that should probably have been amputated, but his patient begged him to save it. 6 months and more than a dozen surgeries later, the leg was finally amputated. The guy went home a shell of his former self when he could have gone home in a couple days and started getting used to life with a prosthetic leg. His uality of life probably would have been pretty good too had he simply gone ahead with the amputation, who knows what 6 tormenting months did to this guy's psyche and overall health.

True, but if the patient was that concerned with his leg it might have been worth it to him, even if it didn't work. Personally I would be willing to risk my life to save one of my limbs, and if 6 months later I lost it anyway I would probably say it was worth the effort. Shouldn't the patient have the right to decide what he is/is not willing endure?

 

[RokChalkJayhawk]

True, but if the patient was that concerned with his leg it might have been worth it to him, even if it didn't work. Personally I would be willing to risk my life to save one of my limbs, and if 6 months later I lost it anyway I would probably say it was worth the effort. Shouldn't the patient have the right to decide what he is/is not willing endure?

There's a lot of debate on this subject. If the guy had been unconscious, my Dad said he probably would have proceeded with the amputation because it was such a bad injury (literally barely attached). Saving things like limbs is very tricky business and there's a lot of research that backs up amputation over trying to save the limb. You can even get an infection and die from a necrotic limb I believe.

While it'd be nice to keep the limb- I think more often than not I go with the prevailing wisdom on a case like this.

Again- it's a tough question, and if you become an orthopedic or vascular surgeon, I'm sure at some point you will have to make a call like this.

 

[nekrogg]

EDIT: A contrived example where the "wacko" is your patient is the good 'ol "You diagnose one of your patients with HIV. His wife is in the waiting room and wants to know what is going on. He asks you not to tell her what is wrong with him. What do you do?"

not much to discuss. this is illegal as far i know and i would definently blow the whistle hands down. id make sure every single pertinent law enforcement agency hears about it. that is by far the worst thing a human being can do and it makes me sick thinking about it!!

http://en.wikipedia.org/wiki/Criminal_transmission_of_HIV

 

[melast]

But what's $75 in the long run? I make $55 a week just donating plasma...you're telling me that someone can't find some way to come up with such a small sum? Plus, let's face it...who ever said healthcare was supposed to be free in the first place? What if I told you I could download a CD for free and use this "little bit of theft" to save $14? What if my desire for the CD is just as strong as my need for the glasses? Wrong is always wrong...unless it's right, which it isn't here lol >).

Umm.. $75 can be a really big deal. When someone is working a ton of hours at underpaid jobs and HAS OTHER EXPENSES BESIDES THE EYE EXAM that they can barely afford (housing, transportation, food, supporting children) it can be hard to find that "extra" cash.

 

[kypdurron5]

Umm.. $75 can be a really big deal. When someone is working a ton of hours at underpaid jobs and HAS OTHER EXPENSES BESIDES THE EYE EXAM that they can barely afford (housing, transportation, food, supporting children) it can be hard to find that "extra" cash.

Certainly I'm not suggesting that there aren't homeless people out there without a dime to their names...but I've said a lot more than what you've quoted...you should keep reading.

...but we're talking about the kind of money you can make anywhere...sell your TV in the newspaper, donate plasma, pull an extra shift, sell some old items on Ebay using library computer/Internet access, etc. You can't tell me that any American can't find a way to scrounge up $75 for a once-a-year expense. Just because someone doesn't want to give up their new 22's to do it doesn't mean they can't afford healthcare- it also doesn't mean that doctors should commit insurance fraud for their unwillingness to make personal sacrifices.

There may be an extremely small minority of Americans who truly cannot scrounge up $75 for a necessary health charge, but I agree with the other poster that those who are unwilling to scrounge up the money far outnumber those who are unable to do it.

 

[asunshine]

Hm, patient sells TV and donates plasma, or doc lets a small charge slide. I don't have to make sacrifices like that for my health care, and I don't think my patients should have to, either. No doctor is going to go broke by doing a good thing for someone else every once in a while.

Bah! We'll have to agree to disagree. But I sure enjoy a debate :-D

From the NIH 8/29/06
http://www.nlm.nih.gov/medlineplus/news/fullstory_37969.html

 

[RokChalkJayhawk]

Do car mechanics give away free repairs? No.

People who are able to should pay for their healthcare. $75 does not break the bank. I'm not going to make someone have to choose between food and healthcare but rather a choice between directTV and healthcare.

 

[QCMD]

There's a lot of debate on this subject. If the guy had been unconscious, my Dad said he probably would have proceeded with the amputation because it was such a bad injury (literally barely attached). Saving things like limbs is very tricky business and there's a lot of research that backs up amputation over trying to save the limb. You can even get an infection and die from a necrotic limb I believe.

While it'd be nice to keep the limb- I think more often than not I go with the prevailing wisdom on a case like this.

Again- it's a tough question, and if you become an orthopedic or vascular surgeon, I'm sure at some point you will have to make a call like this.

This happened to my dad about three years ago. His leg was mangled, and he was unconscious. The doctor decided to save his leg. Three years later, my dad has his leg, but he can't even walk that well, much less exercise (my father was very active beforehand), and he has many nights where he has trouble sleeping b/c he's in pain. Obviously, he wishes his leg had been amputated, and he would get it done now if he could afford it (his insurance won't cover it b/c it's not necessary at this point in time, but it would have been covered if the surgeon had gone ahead and amputated).

 

[kypdurron5]

Hm, patient sells TV and donates plasma, or doc lets a small charge slide. I don't have to make sacrifices like that for my health care, and I don't think my patients should have to, either.

I don't make sacrifices to drive a new car, so I don't think anyone else should have to either. I didn't have to make sacrifices to attend college so I don't think anyone else should have to either. Since my father is a lawyer I don't have to make sacrifices to sue people, so I don't think anyone else should have to either. I make enough money that I don't have to make sacrifices to buy my Viagra, so I don't think anyone else should have to either. I drink booze like water, so I don't think anyone should have to make sacrifices to buy it. What do all these things have in common? They're ridiculous, of course! I'm afraid your socialist propaganda falls on deaf ears >). Of course some people will make sacrifices for things other people have without any hardship! Of course some people will have things that others do not. The very idea that everyone should be able to attain ANYTHING with the same level of ease is not just ridiculous, it threatens the very roots upon which our nation was founded (I'm referring to our capitalist roots, of course). I think that everyone should have some access to healthcare, but it's just crazy suggest that everyone should be able to obtain it without making differential levels of sacrifices. Heck, even under your perfect socialist world sacrifices are made, only you make more sacrifices the richer you become, meaning that the less you work, and the less education you have, the more you let everyone else sacrifice for your medical care.

 

[asunshine]

I don't make sacrifices to drive a new car, so I don't think anyone else should have to either. I didn't have to make sacrifices to attend college so I don't think anyone else should have to either. Since my father is a lawyer I don't have to make sacrifices to sue people, so I don't think anyone else should have to either. I make enough money that I don't have to make sacrifices to buy my Viagra, so I don't think anyone else should have to either. I drink booze like water, so I don't think anyone should have to make sacrifices to buy it. What do all these things have in common? They're ridiculous, of course! I'm afraid your socialist propaganda falls on deaf ears >). Of course some people will make sacrifices for things other people have without any hardship! Of course some people will have things that others do not. The very idea that everyone should be able to attain ANYTHING with the same level of ease is not just ridiculous, it threatens the very roots upon which our nation was founded (I'm referring to our capitalist roots, of course). I think that everyone should have some access to healthcare, but it's just crazy suggest that everyone should be able to obtain it without making differential levels of sacrifices. Heck, even under your perfect socialist world sacrifices are made, only you make more sacrifices the richer you become, meaning that the less you work, and the less education you have, the more you let everyone else sacrifice for your medical care.

Wow. That post really offended me. You have no right to make assumptions about my political beliefs. This conversation is over.

I'm sorry, leahmaria, for hijacking your perfectly good thread.

 

[Sol Rosenberg]

Wow. That post really offended me. You have no right to make assumptions about my political beliefs. This conversation is over.

I'm sorry, leahmaria, for hijacking your perfectly good thread.

I know that I probably shouldn't get involved in this, but why do people "have no right to make assumptions about your political beliefs" based upon your postings? Seems like a natural thing to do to me. NOTE: I am not agreeing/disagreeing with anything anybody said in your little side-thread (I've barely read it in fact,) I just think that your last statement seems a little silly.

 

[kypdurron5]

I know that I probably shouldn't get involved in this, but why do people "have no right to make assumptions about your political beliefs" based upon your postings? Seems like a natural thing to do to me. NOTE: I am not agreeing/disagreeing with anything anybody said in your little side-thread (I've barely read it in fact,) I just think that your last statement seems a little silly.

I agree. I didn't make up the quote "I don't have to make sacrifices like that for my health care, and I don't think my patients should have to, either." If that's not a socialist statement I really don't know what is. Plus, I don't really care what your personal political beliefs are, I merely pointed out the fact that your statement is unreasonable. What you do or don't have to sacrifice for something has nothing to do with anyone else. The only way your statement could possibly be adopted as health care policy would be under socialized medicine. Although, I suppose that would be true under communism as well, at least on the common-worker level. I'm not completely up on my Marx though. Plus, I thought you said you enjoyed a good debate...you can't go around getting offended so easily if you're planning on doing some debating. I never attacked you or your beliefs, only your argument on the basis of healthcare. However, I do commend your idealism. Perhaps I'm too old and corrupted to have such a positive outlook on the subject of national welfare.

Edit- PS: If the most important thing we can do in our lives is keep on living, then what exactly SHOULD we be willing to make sacrifices for? Is it ok if people sacrifice to have a 50" plasma, but not ok if people must sacrifice for healthcare? Which one is more important? (I'm partial to the plasma of course...what else will I display my Xbox 360 on?!?.......I'll let the toe fungus slide for a while)

 

[leahmaria]

to take back my perfectly good thread what do people think about the drunk superior question? obviously you can't let this person operate...do you approach them? their superior?

This seems like a common question at IU, where I'm interviewing soon...any ideas would be great.

 

[Guile]

All I gotta say is kypdurron5 = the man. Good posts, my friend. Too many to quote in this post.

But hey, maybe they're right...

 

[kypdurron5]

to take back my perfectly good thread what do people think about the drunk superior question? obviously you can't let this person operate...do you approach them? their superior?

This seems like a common question at IU, where I'm interviewing soon...any ideas would be great.

Thanks milk. But yes, back to the topic of the thread. My answer to a question like this would resemble the following...I would first attempt to persuade my superior of the fact that they are drunk and would do better to go home. If they will not listen to reason then there's nothing else you can do....tell the head nurse and let them take care of it >) lol. Seriously...I wouldn't mention that during an interview but I think it's a good option. He's your superior and writes your reviews...right? Well this isn't true for the head nurse, so why not address your concerns to him/her and let them do the dirty work of actually taking action or telling someone else...your superior would have no "direct" way of retaliating. Anyway, back to reality. I don't see telling THEIR superior as being a problem. If they come in drunk and try to operate chances are that they will no longer be your superior when all is said and done. Everyone has a boss, so there will always be someone to "tell." Even if you have to call security you'll have them as witnesses, plus any of the nursing staff present. I don't know...I think this is an easy question...what other response could there possibly be? "Oh, I'd lie low and let the wookie win....er, surgeon...wait, where am I again?" Perhaps I'm missing part of the question. Any other ideas?

 

[RokChalkJayhawk]

to take back my perfectly good thread what do people think about the drunk superior question? obviously you can't let this person operate...do you approach them? their superior?

This seems like a common question at IU, where I'm interviewing soon...any ideas would be great.

Keep it in house. I wouldn't call the cops, but you can't just let it slide. Immediately approach a superior, or if you're the superior, send the person home.

 

[kypdurron5]

I was just digging through my master list of actual questions asked....I suggest everyone go into an interview with 3 strengths and 3 weaknesses....those are the hardest for me. Anyway, I came across these two questions:

"What are the top three ethical issues faced by physicians?"

"Can you give me three examples of how honesty affects the doctor-patient relationship? "

I HATE listing questions....1 or two is easy, but coming with 3 for everything is horrible.

 

[asunshine]

I was just digging through my master list of actual questions asked....I suggest everyone go into an interview with 3 strengths and 3 weaknesses....those are the hardest for me. Anyway, I came across these two questions:

"What are the top three ethical issues faced by physicians?"

"Can you give me three examples of how honesty affects the doctor-patient relationship? "

I HATE listing questions....1 or two is easy, but coming with 3 for everything is horrible.

for the first one, stick with anything revolving around life, death or taxes and you can't go wrong

 

[RokChalkJayhawk]

I was just digging through my master list of actual questions asked....I suggest everyone go into an interview with 3 strengths and 3 weaknesses....those are the hardest for me. Anyway, I came across these two questions:

"What are the top three ethical issues faced by physicians?"

"Can you give me three examples of how honesty affects the doctor-patient relationship? "

I HATE listing questions....1 or two is easy, but coming with 3 for everything is horrible.

1)You are pro-life to the core. A woman's baby is literally eating her in utero. Her only chance is an abortion. Do you do it? (I'm sure this is common)

2)Whether or not to treat Republicans.

3)Babies. People? Or devils?

 

[leahmaria]

1)You are pro-life to the core. A woman's baby is literally eating her in utero. Her only chance is an abortion. Do you do it? (I'm sure this is common)

2)Whether or not to treat Republicans.

3)Babies. People? Or devils?

1) does she want it done?

2) sure

3) people

if i got the last two at an interview...

 

[RokChalkJayhawk]

1) does she want it done?

2) sure

3) people

if i got the last two at an interview...

Obviously a joke.

 

[AggieJohn]

I don't feel like reading all of the previous posts, so if it was said earlier then ignore me, but... I don't think coming up with some list of ethics questions is necessary. Just answer them honestly whenever they arrive. Don't listen to people who say you need to have a point and never back down. I think if the interviewer raises a valid counterpoint you need to acknowledge that there are multiple sides to the issue. You could make a list a mile long and never get asked any of those questions. Now if you are making said list to enlighten your mind then go for it

 

[leahmaria]

Obviously a joke.

hey...i need as many practice questions as i can get...and the ones that i don't hesitate on just build my confidence...joke or no

i'm still working on how to respond to the drawing blood out of people's hearts...do you think that could have possibly actually been asked?!?!

 

[RokChalkJayhawk]

hey...i need as many practice questions as i can get...and the ones that i don't hesitate on just build my confidence...joke or no

i'm still working on how to respond to the drawing blood out of people's hearts...do you think that could have possibly actually been asked?!?!

Hah- babies ARE devils though. You just have to watch them when they think you aren't looking.

 

[neurodoc]

I've been thinking of this one a lot: force feeding of hunger strikers. The World Medical Association says it's wrong and docs should not force feed anyone against their wishes, but WMA decisions aren't binding on U.S. doctors or AMA.

This opens up a lot of ethical questions relating to patient self-determination or "autonomy." Going on a hunger strike is essentially a form of suicide (if chose not to eat you will eventually die, and so you will chose to kill yourself). Of course, the hunger striker will say that he is refusing to eat as a form of protest, and that if you respond to his protest (for example by releasing him from prison, withdrawing US troops from Iraq, etc,he will eat his food. Thus, by his calculus, you are killing him...

The WMA, like the UN and other multinational organizations, establishes ethical standards based on "international" consensus.

This is always problematic, since people from different ethnic, religious, and moral backgrounds will frequently disagree. Many in the Muslim Middle East apparently think the death penalty is OK for adulterers and homosexuals. Some people in Brussels seem to think pedophilia is perfectly OK...

In some cultures, suicide is not only condoned, but can be lauded. In others it is viewed as either a sin or a sign of mental illness.

Nick

 

[kypdurron5]

I don't feel like reading all of the previous posts, so if it was said earlier then ignore me, but... I don't think coming up with some list of ethics questions is necessary. Just answer them honestly whenever they arrive. Don't listen to people who say you need to have a point and never back down. I think if the interviewer raises a valid counterpoint you need to acknowledge that there are multiple sides to the issue. You could make a list a mile long and never get asked any of those questions. Now if you are making said list to enlighten your mind then go for it

It never hurts to think about ethical questions...especially if there is a chance you will be asked them. I do agree with you though....you should be confident in your decision, but I think it's also important to communicate that you deeply understand both sides of the issue and recognize that there is not one "correct" response. With every question I try to find an "all-encompassing strategy" to use regardless of the decision or action that is taken. In the case of the drunken superior the ultimate goal is to prevent the doctor from hurting patients, with the Jehovah's Witness question the goal is to figure how to best serve your patients needs. If asked whether you would tell on a cheating roommate the goal is both to protect the integrity of the university and to take the course of action that will result in the most efficient correction of the problematic behavior. With all of these statements I've pointed out the goal of the question and recognized that there are multiple paths one can use to reach a successful solution. Picking one is merely a matter of preference, picking the lesser of two evils, or simply choosing the most efficient solution. Remember, the goal of ethical questions is more to test your ability to think on your feet and speak intelligently when faced with a difficult scenario.

 

[riceman04]

about the jehovah's witness one...i've heard the one about parents not wanting the transfusion for their child. in that case, i would make the argument that the doctor has an obligation to go against the parents' wishes for the sake of the child yadda yadda yadda. but if it's the patient who is refusing the transfusion based on religion, i would be more inclined to respect the patient's right to decide what should be done to his/her body. any thoughts? am i completely off base?

yeah but now there are other options...such as synthetic blood options. Have you heard about how certain ambulance companies have gotten in trouble for testing out these new synthetic blood projects on trauma patients who were unaware they were not receiving real blood...pretty interesting.

 

[zimmie256]

not to sound too girl or anything, but there have been like 3 episodes of grey's anatomy with these situations. it's good to keep up w/ your pop culture

There's also a Law and Order about a religious family (I think Jehovah's Witnesses?) refusing medical care for their child. Took it to court, don't remember the outcome... If only I wasn't stuck at work so I could spend more time on the couch watching TNT's primetime in the daytime to prepare for interviews...