Interview Question: How would you respond?

[Hammergin]

I was asked this at a recent interview and the interviewer continued following up and really pressing me on the issue.

"What would you do if there was a patient in front of you who was about to die and could be saved by your immediate action. However, this action would be against the law and cause you to lose your medical license."

When I asked for clarification on the circumstances, he responded that it was a simple question.

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[werd]

you're probably supposed to say you'd save them, and make an argument of law vs. ethics from there.

 

[gettheleadout]

I'd say there is no right answer; you could argue for one life being more important than the law and say you'd save them, but you can also say that sacrificing one life is worth keeping your medical license so you can save many more in the future, and say you'd let them die. Could you not decide or did you just not want to answer?

 

[Hammergin]

I answered saying that as a physician it was not my place to go against the law. I argued that although the laws that govern medicine aren't perfect, there must be some reason that my action would cause greater harm than good which is why the action is illegal.

The interviewer was confrontational and challenging on this and other ethical questions. Someone who interviewed with him after me had the same experience.

 

[flakpilot]

Good question. I think I would personally say that as a doctor you make an oath to first do no harm: "Primum non nocere", the phrase that serves as a guideline for medical ethics. Then, what can be more harmful than letting a patient die? The patient is already dying whatever you do, how can you really make it worse?. The legal stuff you can discuss/solve later after you save or at least try to save that patient's life...

 

[csmittyB]

Good question. I think I would personally say that as a doctor you make an oath to first do no harm: "Primum non nocere", the phrase that serves as a guideline for medical ethics. Then, what can be more harmful than letting a patient die? The patient is already dying whatever you do, how can you really make it worse?. The legal stuff you can discuss/solve later after you save or at least try to save that patient's life...

And if the patient is DNR? Does Primum non nocere still apply?

 

[emsdan]

Good question. I think I would personally say that as a doctor you make an oath to first do no harm: "Primum non nocere", the phrase that serves as a guideline for medical ethics. Then, what can be more harmful than letting a patient die? The patient is already dying whatever you do, how can you really make it worse?. The legal stuff you can discuss/solve later after you save or at least try to save that patient's life...

I am in no way trying to answer this question, but I would argue that "do no harm" does not apply here. Doing harm implies that some action of yours causes an adverse reaction. In this example, we are simply being asked about inaction.

Additionally, in most states we are allowed to withdraw life-support on patients. This also is not "doing harm" persay; it is merely the removal of a treatment. Despite the fact that we know what said removal will do, we are not causing someone to die, we are allowing their bodies the opportunity to thrive independently.

 

[gettheleadout]

I am in no way trying to answer this question, but I would argue that "do no harm" does not apply here. Doing harm implies that some action of yours causes an adverse reaction. In this example, we are simply being asked about inaction.

Additionally, in most states we are allowed to withdraw life-support on patients. This also is not "doing harm" persay; it is merely the removal of a treatment. Despite the fact that we know what said removal will do, we are not causing someone to die, we are allowing their bodies the opportunity to thrive independently.

Inaction can cause an adverse reaction as much action, and in this case we are not simply withdrawing life support, we are declining (if that's your choice) to perform a life-saving action. Given that we don't have additional information (we're assumedly not stealing an organ meant as a transplant for someone else, while that would technically fit the description), we have to assume that the only conflict is the law. Also, I feel like "thrive" is not the best term to use as you did...

DNR is a different issue, in that case the patient probably signed the form and we are bound by his/her wishes.

 

[flakpilot]

CsmittyB: I would think that if the patient is DNR then Primum non nocere does not apply because in that case you are respecting and you need to respect the patient's wishes. The idea is that the patient made an informed decision when signing the DNR.

emsdan: I see your point. However, the life of that patient could be saved by your inmediate action. In my opinion, if you do nothing in this case and the patient dies, you are responsible for his/her death when you could've at least attempted to try to save him/her. As doctors, isn't our goal/responsability to use all the resources at hand to keep someone alive and as healthy as possible when they are under our care?. Also, although I understand your point of view, I think the example of withdrawing life-support on patients is a completely different situation because in that case the doctors have supposely deeply analyzed the situation and made an informed decision. As I see it, in this case the patient is suddenly crashing/dying and only your inmediate action could save him/her. As I said, I think the legal matters could be analyzed/disccused/solved later. The patient's life should be the priority I think.

Again, I'm no expert I'm just expressing my opinion. Would love to hear other people's opinion .

 

[ModerateMouse]

As I said, I think the legal matters could be analyzed/disccused/solved later. The patient's life should be the priority I think.

But don't you think that this is an overly general question?

As gettheleadout keenly pointed out, we do not know what law is about to be broken. What if the law we would need to break is to kill a healthy patient and transplant his heart into the dying patient?

I would probably have a hard time answering the question "as is", and would try to build two hypothetical scenarios (e.g., A: if the law being broken would not cause anyone great harm, B: if it would).

But even if I start answering this way, the question is still a potential trap.

After all, didn't society create laws with the goal of minimizing harm to all and respecting the moral traditions of the dominant culture?

I can see this question going very badly, depending on the interviewer's follow up.

In fact, I don't really know what the best way to answer is.

 

[rHinO1]

I think as a physician, you are expected to operate within certain rules. These rules come from the government, hospital policy, and insurance companies. I can imagine that doctors often feel helpless in many situations because they are bound by these rules. However, the answer is to support the change of the laws/policies, not to disregard them. Be an agent of change, and function within the system that is in place. Therefore, in the scenario above, I would do everything I could for the patient within the law.

There was probably no right or wrong answer to that question. The interviewer was probably looking to see you had a well thought out and well supported answer. An alternative answer to mine above, may be that you would save the patient then plead your case later. You made the decision to save the patient and accept the consequences, and you hoped the court would be lenient on you due to the circumstances.

 

[flakpilot]

I agree with you guys, it is definitely a tricky question. And of course, it depends on how you imagine the scenario ModerateMouse. You definitely wouldn't do harm to another patient to save the life of this one. And I agree with you Rhino1 that rules and laws are there for a reason. But also in some extreme cases I think rules are meant to be broken. In this case, I might be silly for putting my medical career in danger and potentially losing my medical license but in the scenario I pictured this, which was me, the patient and no one else around I think the patient should be my priority. Of course in the case someone else who could legally intervene was reachable I would inmediately reach for him/her and I would do everything I could do legally before breaking the law I think. If this was not possible however, I think I would just help the patient and beg the judge in charge of my case to let me keep my license lol

 

[Shaolin]

I would say "I would take immediate action to save the patient's life... then hire a damn good lawyer!"

Edit: I have to say though, I hope he (the interviewer) didn't add circumstances AFTER you answered your question just to try and poke holes in your reasoning. The circumstances do matter, and such a broad "simple" question does not have a simple answer.

 

[298609]

i read the question and immediately thought that you were witnessing a lethal injection and the action would be interfering and saving the guy's life.


prob not the best choice.

so obv there are multiple scenarios where the question could apply and very different outcomes ranging from obbbbbvvviouuussslllly save the person ignore law and the exact opposite. just be able to back up what you say with your actual beliefs and ethics. i've always thought that these questions are more to make sure you have a BACKBONE and MORALS that you believe in than making sure you know the right answer.

 

[Iso4ane]

Well MLK jr said in his letter from a Birmingham Jail that law can and should be broken if they are not moral. (Insert Ethical Discussion) In my mind any law that prevents one from saving a life (assuming it does not come at the cost forcing one to to lose their life) would be moral.

And like many other people say, for ethic problems dealing with patients, the patient should nearly always come first.

So I say save the guy

 

[Narmerguy]

Well MLK jr said in his letter from a Birmingham Jail that law can and should be broken if they are not moral. (Insert Ethical Discussion) In my mind any law that prevents one from saving a life (assuming it does not come at the cost forcing one to to lose their life) would be moral.

And like many other people say, for ethic problems dealing with patients, the patient should nearly always come first.

So I say save the guy

I think giving ourselves license to break the laws when we believe they're immoral opens the door to a very slippery slope. Why can a lawyer not also interpret the law as he chooses? Or an architect? Or a nurse?

If every individual believes he has the right, even if only in nominal cases, to bypass the law, we leave ourselves open to laws without meaning. Laws are only useful if everyone agrees that, despite whatever flaws may be present, that they will follow them and that if these laws do seem wrong, they will either act as a group to change them.

 

[runawayclock]

Obviously, it would depend on what law you're breaking, and why it would be illegal to save the patient but from my law school friends apparently the general rule would be to save the person, and then deal with whatever consequences. Even if someone has DNR tattooed on them, unless you see their lawyer in front of them with papers saying that this DNR order is legally binding, you're supposed to save them and deal with whatever legal consequences later because you don't know whether they got the tattoo for fun, etc.

In cases of lethal injection, i think the only legal option is non-participation rather than interference.

This question could be about any number of morally ambiguous circumstances... abortion (therapeutic - who is the patient you're trying to save? the mother or the fetus?; if abortion is illegal and the mother is trying to abort it herself unsafely, should you help her? etc), executions, etc...

 

[circulus vitios]

Walk out on the interview.

 

[Kalyx]

Obviously, it would depend on what law you're breaking, and why it would be illegal to save the patient but from my law school friends apparently the general rule would be to save the person, and then deal with whatever consequences. Even if someone has DNR tattooed on them, unless you see their lawyer in front of them with papers saying that this DNR order is legally binding, you're supposed to save them and deal with whatever legal consequences later because you don't know whether they got the tattoo for fun, etc.

Well, haha, if you were to see someone with a "DNR" tattoo, you'd first have to assume that you don't know what it means!

However, the patient could have an advance directive that contains a true DNR order, and if you can see that in his/her medical records, then you should not intervene, as doing so would violate the patient's autonomy and legal assertion of desired treatment/non-treatment.

~Kalyx

 

[gettheleadout]

I think giving ourselves license to break the laws when we believe they're immoral opens the door to a very slippery slope. Why can a lawyer not also interpret the law as he chooses? Or an architect? Or a nurse?

If every individual believes he has the right, even if only in nominal cases, to bypass the law, we leave ourselves open to laws without meaning. Laws are only useful if everyone agrees that, despite whatever flaws may be present, that they will follow them and that if these laws do seem wrong, they will either act as a group to change them.

Civil disobedience?

 

[morning]

IRL, if you didn't intervene in this situation, you'd get the feces sued out of you by the patient's next of kin and may end up losing your license anyway. What a silly question. I know that you can't actually tell an adcom that their question is BS, and you have to play along and answer it as best you can, but...what a silly question. It's like being asked "if God is all-powerful, can he make a circular triangle?"

In this hypothetical situation that would almost certainly never exist, if you DID save the patient, and lost your medical license, you could probably go to the media and turn it into a ****storm, and it would probably end up in your favor. If you DIDN'T save the patient, the patient's family could easily go to the media and turns it into a ****storm.

 

[PremedGunner]

I think giving ourselves license to break the laws when we believe they're immoral opens the door to a very slippery slope. Why can a lawyer not also interpret the law as he chooses? Or an architect? Or a nurse?

If every individual believes he has the right, even if only in nominal cases, to bypass the law, we leave ourselves open to laws without meaning. Laws are only useful if everyone agrees that, despite whatever flaws may be present, that they will follow them and that if these laws do seem wrong, they will either act as a group to change them.

change is inacted through the breaking of laws. whoever breaks the law can argue it in court, and if the judge agrees, new precedent is set. there is no "act as a group to change them." there must be a case.

 

[juliedi]

I agree with the "no right or wrong answer" sentiment. I think all an interviewer is looking for is that you can think about a tricky situation, form an opinion, and articulate your reasons.

I was chatting recently with an MD I know who used to conduct med school interviews, and he told me he'd ask some kind of similar question to every applicant just to see how they think.

 

[Adaggiote]

This is BS. First of all, it is convoluted. You are both conservative and increase the quality of life around you; this would be by performing the operation. On the otherhand, you would probably end up like Jack Kevorikian. Wiki him.....

 

[298609]

"if God is all-powerful, can he make a circular triangle?"

.

you should see the face i am still making a whole 60sec after reading that.

my mind is BLOWN



a triangle isn't really a triangle...and circle isn't a circle....everything is nothing.......

 

[Scarletblack]

I was asked this at a recent interview and the interviewer continued following up and really pressing me on the issue.

"What would you do if there was a patient in front of you who was about to die and could be saved by your immediate action. However, this action would be against the law and cause you to lose your medical license."

When I asked for clarification on the circumstances, he responded that it was a simple question.

It's a person's life. That **** is even more expensive than a medical degree.

Save the patient and **** the license. XD

 

[jvesco22]

It's a person's life. That **** is even more expensive than a medical degree.

Save the patient and **** the license. XD

brb throwing 10+ years of my life down the drain to save a crackhead...

 

[johnw15]

There is no right or wrong answer. Just go with what you are passionate with and be ready to back it up with logical reasoning.

 

[PremedGunner]

there is a right answer, generally you must save the patient. any law that forbids the saving of a patient is an immoral law. (not including dnr type situations.)

 

[Rendar5]

speaking from the other side of the pond, this is way too tricky of a situation. You have to do what is both best for the patient, for you, and for your family. And there is not necessarily a right answer.

I know that if it is a case where I am assured of losing my license, that I likely would not pull the trigger. I am not willing to put my family's livelihood on the line and leave all my other patients without medical care for the time being unless there is a damn good reason to. And simply saving someone's life is being way too vague. I'm not sure people who haven't made literal life and death decisions and had someone's life in their hands can realize that "saving a life" is a much more complex concept than it sounds. Not all "saving a life"'s are equivalent.

 

[itellitlikeitis]

There is no right or wrong answer. Just go with what you are passionate with and be ready to back it up with logical reasoning.

Exactly. The situation is purposely left ambiguous to force the interviewee to defend one of 2 possible positions. Neither one is more right than the other because you don't know the circumstances so just pick one and give a coherent argument

 

[omgyou8myrice]

There is no right answer. The purpose of the question is to see how well you can argue a point, even after the interviewer questions it. The beauty of the question is that no matter what answer you say (as long as you give one), they can challenge it by going the other way. I absolutely believe that if you had said the other answer, he would've argued that as well.

Long story short, pick whichever answer you think you can best defend, and proceed.

I personally would say that losing my medical license that could potentially save thousands of lives in the future wouldn't be worth one person's life, and I would stick with that no matter what he said.

 

[Longshanks]

brb throwing 10+ years of my life down the drain to save a crackhead...

Get used to it. You'll be dealing with plenty of drug abusers and less fortunate people than yourself during your career.

 

[jvesco22]

Get used to it. You'll be dealing with plenty of drug abusers and less fortunate people than yourself during your career.

I don't think you understood the context of my post.

 

[hiyaman]

Do a lot of interviewers enjoy asking these "loaded gun" type of questions?

 

[itellitlikeitis]

Do a lot of interviewers enjoy asking these "loaded gun" type of questions?

Only a few interviewers asked me these types of questions. They just want to know that you can 1) take a stance when faced with some ethical dilemma that obviously has no right or wrong answer and 2) make an argument and respond to criticisms of your stance since they can attack you using arguments from the opposing stance you took.

It just depends on your interviewer. For the most part, my interviewers let me dictate the interview because they almost always started out with "So tell me about yourself". It was usually the interviewers who had their own pre-written interview questions in hand that ended up asking these types of questions for me

 

[Longshanks]

I don't think you understood the context of my post.

I did, but it wasn't the most original use of 4chan humor so I disregarded it. Nevertheless, what I said isn't wrong.

 

[jvesco22]

I did, but it wasn't the most original use of 4chan humor so I disregarded it. Nevertheless, what I said isn't wrong.

I'm not into that 4chan stuff broski, I'm a miscer for life. You mirin'?

 

[familyaerospace]

I would have said that it was a hard question. The most logical side of my brain would say "The needs of the many outweigh the needs of the few... Or the one" (thank you Star Trek) and lose the patient, but keep the license so I would still be able to treat other patients.

I would then state that I know from my past experiences that I wouldn't do that and that I would save the patient at the risk to myself. I could then use about four experiences in my past to back this up.

 

[VikingLegacy]

baleeted

 

[TriagePreMed]

I answered saying that as a physician it was not my place to go against the law. I argued that although the laws that govern medicine aren't perfect, there must be some reason that my action would cause greater harm than good which is why the action is illegal.

Remember slavery? Having those blacks free is obviously greater harm

I can understand why this guy got annoyed by a candidate that didn't have the balls to at least dabble within the grays of life.

 

[jvesco22]

> Guy poasts chan meme
> No, literally a picture that originated on 4chan and was popularized by 4chan
> Guy then claims he doesn't do 4chan

TROLLFACE.JPG

not sure if srs. You mirin jobra? Lettuce be cereal. I've said it before and I'll say it again. Only a certain type of person visits that 4chan website and frankly I'm not the type. I misc brah. I have no idea where siht originates from, but if it's on the misc then I rep it ya dig?

And how do some of you guys recognize everything as being from 4chan? Must frequent it lots eh...

I'm flippin chickens all day errrrrrrrrrry day, no problem and I'm so 'hansome'. Come at me bro...