Yep. Folks unfortunately sometimes think that because a patient is dying they can do no harm to that patient no matter what they do.... You and I having actually been trained, seen numerous situations understand harm can be done even to the dying.....
There in is the true ethics. doing the ethical thing is not always easy. it is far easier for me to slice open a patient then admit there is nothing I can do. Only the ignorant will go to sleep well after there wild bill excursion believing they somehow helped the patient by.... killing them faster on a table.
To be fair, this concept can be difficult to grasp. Until you have actually caused harm to a patient, it is easy to be cavalier. Even when that harm is a known complication (ie, PTx from a central line) it is soul-disturbing. I've often heard non-medical people claim that malpractice suits are "no big deal" to physicians since the insurance pays. They neglect the psychological toll.
So yes, you can harm the dead and the impending dead and in the process, harm yourself as well (legally, ethically and psychologically).
But you never directly answered my question. I restated OP's question as a scenario in which you are, in fact, trained, but not permitted to do so without supervision. Big difference there between that and having "no idea HOW". In that case, of course it's not right.
Sorry...wasn't trying to misinterpret your query. As I understood it, you were referring to an EM physician as being "trained" to operate but couldn't without supervision. In that case, as I stated, the EM physician is NOT trained to operate, with or without supervision, and has "no idea how." He may be able to crack the chest and x-clamp the aorta, but then cannot go further because he has no idea how and privileges which allow it.
I think my later scenario, me doing Vascular Surgery, appears to be akin to what you are asking about. I am trained to do Vascular Surgery but do not have privileges to do so. And no, I still would not do it because in highly artificial scenarios such as the one painted, if the patient will not survive without an immediate operation, he will likely die regardless of whomever is operating on him. All I've done is hasten the death and left his family with a bloated, scarred corpse.
Again, you and I aren't in disagreement. We never were.
😕 I'm not sure where you got the idea that I thought we were.
The question had nothing to do with scope. At least, as far as I interpreted it. Rather, it had to do with standing orders, or the equivalent (I come from an EMS background). If a person is trained to perform a function but not permitted to do them without supervision, that function is within their scope of practice, even if they're not privileged to perform it without supervision.
I disagree. If you are not privileged to perform function X, then it is NOT within your scope of practice. I've never been an EMS provider so cannot comment on whether that is SOP in your business, but it is not in medicine. Perhaps it is philosophically - ie, I am trained to do surgery so that is my "scope of practice" but realistically we all have limits on our scope of practice. Even fully trained surgeons are not allowed to do every surgical procedure they want.
And I thought the OP's question DID have to do with scope of practice - although in fairness, there were so many inaccuracies/inprobabilities in the scenario that it could have been interpreted in many ways (ie, many pre-meds get the idea that EM physicians are doing trauma surgery). Culture of Grey's Anatomy/ER/Scrubs, etc.
Sounds like he posted the answer without reading your post.
