Medical Ethics for Interviews and for Life

[CodeBlu]

So, for those who are starting interviews early in the season, or for those anxiously waiting. Here is a book that I am very happy I purchased from my friend. It's an expensive book, but it's clear, concise and to the point.

If anyone wants to talk medical ethics, please feel free to post and discuss here. I have heard that most medical ethics questions at interviews are not terribly difficult. But, it is an interesting topic to discuss. Plus, it's a good break from secondary writing and obsessing over interviews!

http://www.amazon.com/Doing-Right-P...=sr_1_1?s=books&ie=UTF8&qid=1311462658&sr=1-1

The book is called Doing Right. Fitting I would think.

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[aSagacious]

So, CB, with regards to abortions when do you define the beginning of life?

 

[Mithril]

That is the same book I used for a basic foundation of medical ethics for my interviews, but I would add a disclaimer that many of the examples and laws are from a Canadian perspective.

 

[CodeBlu]

So, CB, with regards to abortions when do you define the beginning of life?

Going to play the religious card and the scientific card here.

In my opinion, the beginning of life is not when conception happens. Although this would go against every intro bio class you've had, my reasoning is such, conception is a fusion of chromosomes, and essentially a fetus is a parasite in the mother's womb.

The Jewish Talmud states that a fetus's life is less valuable than a woman's. If the woman's life is endangered by the pregnancy, it requires an abortion, since your duty is to the mother first. However, if the most of the fetus has emerged from the womb, then you cannot kill the fetus to save the life of the mother, since you cannot choose between one human life and another.

Now, the scientific card is when the fetus would be viable to sustain it's own life without the mother.

Someone else wanna fill in the gap here...

 

[CodeBlu]

That is the same book I used for a basic foundation of medical ethics for my interviews, but I would add a disclaimer that many of the examples and laws are from a Canadian perspective.

They might be... but they are still applicable. Offers another perspective I think on ethics I learned in the US.

 

[Mithril]

The general stuff is applicable, but I'm just saying American premeds might not be able to relate to it as well because specific guidelines refer to Canadian charters and legal documents like the Criminal Code of Canada or legal precedents set in Canadian courts but not necessarily in US courts.

 

[235788]

too cool for a library? I'll be sure to pick it up. The last ethics book i read was pro-euthanasia so i'll be interested in different stances.

 

[CodeBlu]

The general stuff is applicable, but I'm just saying American premeds might not be able to relate to it as well because specific guidelines refer to Canadian charters and legal documents like the Criminal Code of Canada or legal precedents set in Canadian courts but not necessarily in US courts.

Either way I thought it was a good book to complement my other ethics stuff.

In any event... the ethics discussion should be interesting.

 

[deleted393595]

In any event... the ethics discussion should be interesting.

Maybe we can have a thread specifically for discussing various ethical dilemmas? Or would that eventually turn into a troll war?

 

[235788]

Maybe we can have a thread specifically for discussing various ethical dilemmas? Or would that eventually turn into a troll war?

the later

 

[CodeBlu]

Maybe we can have a thread specifically for discussing various ethical dilemmas? Or would that eventually turn into a troll war?

I think we can manage to talk about serious ethical dilemmas. We just have to be vigilant with reporting the nonsense. This is supposed to be a resource. We should focus on making it one.

 

[aSagacious]

...the scientific card is when the fetus would be viable to sustain it's own life without the mother.

Interesting. I tend to subscribe to the sentient-ism approach, though it is admittedly difficult to discern between reflexes and voluntary responses to painful stimuli in fetuses.

 

[Doc of the Walk]

I know this doesn't pertain to the topic but, you really like SDN don't you?


(Look to the right)

 

[CodeBlu]

I know this doesn't pertain to the topic but, you really like SDN don't you?


(Look to the left)

Yes, I do...

Creepy. But cool at the same time.

I think you meant look right...

 

[Doc of the Walk]

Yes, I do...

Creepy. But cool at the same time.

I think you meant look right...

I did, yeah, that was the first time I've ever seen something like that...

 

[aSagacious]

I did, yeah, that was the first time I've ever seen something like that...

To his defense, the posts were at ungodly hours of the night when the rest of us normal pre-meds were sound asleep (unless you were in a different timezone when you took the screenshot).

 

[CodeBlu]

I did, yeah, that was the first time I've ever seen something like that...

There's a lot of stupid stuff that goes down here. I hope to be a school administrator on day, and have a say in admissions etc. I'd like to give back to SDN what the legends like SN2ed, Catalystik, LizzyM have given to us.

Imagine your life without SDN... now imagine your life with SDN... sure the neuroticism kicked up a notch. But I'd rather know than not know. Ignorance may be bliss, but knowledge is power. I love cliches.

 

[CodeBlu]

To his defense, the posts were at ungodly hours of the night when the rest of us normal pre-meds were sound asleep (unless you were in a different timezone when you took the screenshot).

Yeah what time zone were you in? Cuz those hours look off...

Then again...I am up at ungodly hours of the night... frequently.

 

[gettheleadout]

Interesting. I tend to subscribe to the sentient-ism approach, though it is admittedly difficult to discern between reflexes and voluntary responses to painful stimuli in fetuses.

The question should be phrased to address the beginning of "personhood" instead of life. Ova and sperm are undoubtedly living, as are zygotes. (just saying)

 

[Eric01]

Now, the scientific card is when the fetus would be viable to sustain it's own life without the mother.
..

I disagree, the ability to sustain one's own life independently should not be included in the definition of life. Otherwise mentally ******ed/handicapped individuals would not be considered alive.

 

[CodeBlu]

The question should be phrased to address the beginning of "personhood" instead of life. Ova and sperm are undoubtedly living, as are zygotes. (just saying)

Sure GTLO, living and personhood are two different things.

Personally, I don't put much merit into the whole...

"A baby's life starts before conception bla bla bla"

This is also why the catholic church doesn't condone masturbation. Doesn't want your future children to end up in an aloe vera kleenex.

On youtube lately, I've seen an ad with a guy named Sergio who is a mormon and a scientist, who "wants to find out the truth". I agree that religion and science do not have to be mutually exclusive. But there should be some buffer like philosophy in the middle to mediate some tough battles. It's hard to argue with a logically sound premise and conclusion.

 

[CodeBlu]

I disagree, the ability to sustain one's own life independently should not be included in the definition of life. Otherwise mentally ******ed/handicapped individuals would not be considered alive.

Your argument doesn't follow any sort of logic. You're allowed to disagree. But mentally ******ed/handicapped individuals can be born just as healthy babies can.

I am saying, in utero, aborting the fetus when it is able to live as a separate entity from the mother is when it is alive. Cuz without the mother, it wouldn't be alive. See the logic?

 

[aSagacious]

I agree that religion and science do not have to be mutually exclusive. But there should be some buffer like philosophy in the middle to mediate some tough battles. It's hard to argue with a logically sound premise and conclusion.

That's exactly what I was trying to establish.

Premise 1: It is immoral to 'kill' a 'human life'
Premise 2: A 'human life' begins at '---'
Conclusion: Therefore, we ought not abort after '---' occurs

 

[FattySlug]

Can anyone post what ethic questions that have been asked or could be asked? We might as well spend time thinking about it while waiting for interview invites.

 

[CodeBlu]

That's exactly what I was trying to establish.

Premise 1: It is immoral to 'kill' a 'human life'
Premise 2: A 'human life' begins at '---'
Conclusion: Therefore, we ought not abort after '---' occurs

I know

I see what you did there.

Premise 1: It is immoral to kill a human life.
Premise 2: A human life begins when it is able to sustain itself separate from it's mother's placenta.
Conclusion: Therefore.... (go for it saggy)

 

[CodeBlu]

Can anyone post what ethic questions that have been asked or could be asked? We might as well spend time thinking about it while waiting for interview invites.

That's what this thread is for... I've got 2 good books here... will post new ones when we exhaust the current one.

 

[aSagacious]

Premise 1: It is immoral to kill a human life.
Premise 2: A human life begins when it is able to sustain itself separate from it's mother's placenta.
Conclusion: Therefore.... (go for it saggy)

I hate being put on the spot... I crumble under pressure

 

[Eric01]

Your argument doesn't follow any sort of logic. You're allowed to disagree. But mentally ******ed/handicapped individuals can be born just as healthy babies can.

No the logic is then when a mentally handicapped person is born, they are unable to survive without assistance for the rest of their life. An unborn fetus also needs assistance sure, just as the mentally handicapped person, but does that mean they're not alive?

 

[FattySlug]

I think I am gonna go with when the baby resemble a human abortion should not be allowed. When is that anyway? First trimester?

 

[aSagacious]

I think I am gonna go with when the baby resemble a human abortion should not be allowed. When is that anyway? First trimester?

Depends, even that definition is muddy. I personally think that newborn infants look like aliens with their enormous heads.

 

[CodeBlu]

No the logic is then when a mentally handicapped person is born, they are unable to survive without assistance for the rest of their life. An unborn fetus also needs assistance sure, just as the mentally handicapped person, but does that mean they're not alive?

You're losing sight of the objective... we're not saying to abort handicapped fetuses. We're talking about BASIC LIFE FUNCTIONS, breathing, circulating your own blood.

I think I am gonna go with when the baby resemble a human, abortion should not be allowed. When is that anyway? First trimester?

I would say after week 16-18. But that's from my embryology class... depends on a variety of factors.

 

[CodeBlu]

Depends, even that definition is muddy. I personally think that newborn infants look like aliens with their enormous heads.

You look like an ALIEN!

Fun fact though: Did you know that your eyeballs are the same size they were when you were born?

 

[FattySlug]

Depends, even that definition is muddy. I personally think that newborn infants look like aliens with their enormous heads.

Yea I know but we are many times forced to make arbitrary decisions. I don't think we can come up with any clear cut rule here. Anyone knows the current law on this?

Edit: never mind just look it up and it varies from state to state. sounds complex.

 

[CodeBlu]

Yea I know but we are many times forced to make arbitrary decisions. I don't think we can come up with any clear cut rule here. Anyone knows the current law on this?

It's a gray area... sort of like when you have a 29 on the MCAT... vs a 31...

30 is great. But 1 point higher is that much better.

 

[aSagacious]

Yea I know but we are many times forced to make arbitrary decisions. I don't think we can come up with any clear cut rule here. Anyone knows the current law on this?

Hence the inherent impossibility of objectively answering ethical questions.

 

[CodeBlu]

Hence the inherent impossibility of objectively answering ethical questions.

Here's my logic for answering an ethical question.

Think out loud...

1) State what you think the issue is and what needs to be addressed
2) Present the pro side (agree)
3) Present the con side (disagree)
4) Synthesize a rule.

Oh look... it's the MCAT writing sample. Maybe that's why they make us do it...

 

[FattySlug]

Would legalizing marijuana be a potential question? It's controversial but not ethical right?

 

[aSagacious]

Here's my logic for answering an ethical question.

Think out loud...

1) State what you think the issue is and what needs to be addressed
2) Present the pro side (agree)
3) Present the con side (disagree)
4) Synthesize a rule.

Oh look... it's the MCAT writing sample. Maybe that's why they make us do it...

Well done... you've now unlocked the acheivement "MCAT Writing Like a Boss."

However, in practice #4 is the hang-up in almost every ethical discourse that I've ever participated in.

 

[CodeBlu]

Well done... you've now unlocked the acheivement "MCAT Writing Like a Boss."

However, in practice #4 is the hang-up in almost every ethical discourse that I've ever participated in.

Well I did get a T... and I type pretty fast. I wrote at least 1000 words on my essays. I think longer equals more marks... confluent BS for the win.



Exactly... the point is to remain neutral.

Present premise 1 and 2 to your interviewer. Hopefully it's a conversation, and there will be dialogue to facilitate the synthesis of your argument.

 

[Eric01]

You're losing sight of the objective... we're not saying to abort handicapped fetuses. We're talking about BASIC LIFE FUNCTIONS, breathing, circulating your own blood.
.

Well I was just debating the point of assistance in general. If you're going to be specific about the type of assistance i.e. providing essential circulation etc. then that goes into the realm of philosophy.

However, never in nature will you see a dead object go to an alive object. Once a person is dead, they may never become alive. Therefore, the reasoning that a dead object suddenly spring to life once it gets a circulatory system is beyond my fathoming. It is only left to reason the object was alive to begin with. My point of emphasis is that a thing is considered alive once it starts undergoing mitosis.

 

[CodeBlu]

Well I was just debating the point of assistance in general. If you're going to be specific about the type of assistance i.e. providing essential circulation etc. then that goes into the realm of philosophy.

However, never in nature will you see a dead object go to an alive object. Once a person is dead, they may never become alive. Therefore, the reasoning that a dead object suddenly spring to life once it gets a circulatory system is beyond my fathoming. It is only left to reason the object was alive to begin with. My point of emphasis is that a thing is considered alive once it starts undergoing mitosis.

I disagree. Medical resuscitation does exactly that... you're flat lined... epinephrine and electrical shock brings you back to life.

You want to talk mitosis? Sure... Molecular Cell Biology by Lodish et al. defines the cell as the smallest unit of life. The word they chose was UNIT... it's a piece of something. Not yet made whole. The human body is an intricate puzzle that takes 9 months to put together. So until you're born... technically you're not REALLY alive.

 

[Eric01]

I disagree. Medical resuscitation does exactly that... you're flat lined... epinephrine and electrical shock brings you back to life.

You want to talk mitosis? Sure... Molecular Cell Biology by Lodish et al. defines the cell as the smallest unit of life. The word they chose was UNIT... it's a piece of something. Not yet made whole. The human body is an intricate puzzle that takes 9 months to put together. So until you're born... technically you're not REALLY alive.

Only if the resuscitation is performed before cellular death of the brain occurs. I mean we can go into these exceptions but I think you know what I meant by death as in the permanent variety.

I wouldn't consider just because a person's heart stops that they're dead, just temporarily incapacitated from a lack of oxygen/blood supply, it only becomes permanent if intervention isn't given immediately.

 

[CodeBlu]

Only if the resuscitation is performed before cellular death of the brain occurs. I mean we can go into these exceptions but I think you know what I meant by death as in the permanent variety.

I wouldn't consider just because a person's heart stops that they're dead, just temporarily incapacitated from a lack of oxygen/blood supply, it only becomes permanent if intervention isn't given immediately.

So... do you see the contradiction here? Can cells divide without a medium/nutrients in which to do so?

No... they can't. Thus, until you are able to undergo mitosis on your own... without your mothers multipotent stromal cells invading your belly... you're not doing jack.

 

[aSagacious]

This is why I like my sentient-ism argument. I find no ethical dilemma in 'killing' a cell, or a living isolation of tissue, or any whole non-sentient organism. For those who are about to ask, yes that includes human vegetables IMO.

 

[CodeBlu]

This is why I like my sentient-ism argument. I find no ethical dilemma in 'killing' a cell, or a living isolation of tissue, or any whole non-sentient organism. For those who are about to ask, yes that includes human vegetables IMO.

Vegetables don't have feelings.

SO, next topic? Everyone satisfied?

 

[aSagacious]

SO, next topic? Everyone satisfied?

Ooh, ooh, pick me! Do the Heinz Dilemma

 

[CodeBlu]

Ooh, ooh, pick me! Do the Heinz Dilemma

I like this one. For those who don't want to click the link for the background info...

In Europe, a woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. The drug was expensive to make, but the druggist was charging ten times what the drug cost him to make. He paid $200 for the radium and charged $2,000 for a small dose of the drug.

The sick woman's husband, Heinz, went to everyone he knew to borrow the money, but he could only get together about $ 1,000 which is half of what it cost. He told the druggist that his wife was dying and asked him to sell it cheaper or let him pay later. But the druggist said: "No, I discovered the drug and I'm going to make money from it." So Heinz got desperate and broke into the man's store to steal the drug-for his wife. Should the husband have done that? (Kohlberg, 1963)."

 

[aSagacious]

^ I think we're gonna need more than 2 premises for this one

 

[CodeBlu]

^ I think we're gonna need more than 2 premises for this one

Let's save that for the advanced class.

How about this one...

Placebo (Ethical Decision Making)
Dr Smith recommends homeopathic medicines to his patients. There is no scientific evidence or widely accepted theory to suggest that homeopathic medicines work, and Dr Smith doesn't believe them to. He recommends homeopathic medicine to people with mild and non-specific symptoms such as fatigue, headaches and muscle aches, because he believes that it will do no harm, but will give them reassurance.
Consider the ethical problems that Dr Smith’s behaviour might pose. Discuss these issues with the interviewer.

 

[Eric01]

So... do you see the contradiction here? Can cells divide without a medium/nutrients in which to do so?

No... they can't. Thus, until you are able to undergo mitosis on your own... without your mothers multipotent stromal cells invading your belly... you're not doing jack.

Wait what? It is the fetus's cells that are dividing in the mother's womb. They are doing jack. It isn't the mother that's dividing those cells for them, it's their own intrinsic property.

I don't think you can differentiate death. Death in the context of the outside world is the same as death in the context of the womb. If you place a man who has died into whatever culture you wish, it isn't going to do anything. The cells won't divide because the person is dead. If you place the fetus in the womb which is a right culture for its environment, its cells will divide because it is alive.