is this ethical?

[GoofyDoc]

Hi. I was just debating the following hypothetical scenario with someone and I'm not sure what the right answer is. Supposing as a med student/resident/attending you encounter a case that you find to be highly disturbing. There are lots of things that we may find to be disgusting or awful and we are supposed to treat nonetheless, but I would assume that not everyone would be able to handle every single case that comes their way. I'm not talking about controversial things like abortion, assisted suicide, etc - I mean, what if you get a case you just feel tremendously overwhelmed by - that for some reason it disturbs you significantly and makes you doubt your ability to handle it - do we treat the patient or can we pass it on to someone else who isn't as disturbed by it? Thanfully, I have never been in such a situation, but we have got a long career ahead of us and everything is a possibility.

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[freshity]

in this hypothetical, are you disturbed by the medical aspects of the case, or by other aspects? i think that's an important first question and may impact how you proceed...

 

[Gfunk6]

Ultimately you have to keep the patient's best interests foremost in your mind. If you think you will provide substandard care b/c of your discomfort, then it would follow that you should refer him to a colleague. Of course, if the problem is emergent or life-threatening, you had best suck it up and do what needs to be done.

 

[GoofyDoc]

in this hypothetical, are you disturbed by the medical aspects of the case, or by other aspects? i think that's an important first question and may impact how you proceed...

Yes, I'm talking about being disturbed by the medical findings.

Interesting how your username shows up in the quote.

 

[TheThroat]

From a surgical standpoint, I have never seen a patient with something that disturbed or disgusted me. That said, if this situation arose, you just have to recuse yourself from the OR or from seeing the patient. We aren't superheroes and can't handle everything. But on the other hand, we have to be able to handle the basics of human pathology (stool in a belly wound, emesis, pus from anywhere in the body, parasitic infections, getting blood/saliva/urine on you, etc).

 

[Annette]

It is amazing what you will become tolerant of. I couldn't stand seeing/hearing/smelling vomit. During a code, I got doused with it- ET tube in the esophagus, spurting with each chest compression. Now, it doesn't bother me as much. Smells still get to me at times. Had a patient who had the worst smelling bowel movement, the nurses hadn't cleaned him up yet, and I was in a hurry. Just stick an alcohol pad in a mask ("I'm getting a cold I don't want to spread" works well as an explination).