Ethical Questions Answers

1. The attending surgeon cut a nerve during surgery and repairs it. The attending says “Leave that out of your op note.” What do you do?

ANY incident is REPORTED TO THE PATIENT in post care or PACU; wait until they are awake and oriented. Then include it in the note. Honesty is the best policy. There was a similar situation not too long ago. Now a resident is getting sued, along with the doctor. There is a long process for false or miswritten documentation.

2. In the OR: Attending seems “off.” You have a suspicion that he was drinking and the surgery starts in 15 minutes. What do you do?

My gut feeling tells me that this is wrong, and my ethics training tells me that this should not occur. There is a proper place and time to be drinking, and in this situation, it’s not acceptable. But first I would like to talk to the doctor himself to move the case another day when his mind is not influenced or impaired.

If that fails, go up the hierarchy. I would contact another resident to consult him. I would go up the hierarchy and tell the rotating nurse, the anesthesiologist, etc.

3. You’re in the ED. Patient with a retained foreign body, andthey are septic. You call the attending, they say, “I’m busy. Do I need to come?” How do you respond?

Use your knowledge of medicine, follow your gut feeling, and don’t be afraid to make your attendee come in. If they meet SIRS criteria and have a portal of entry, then they are septic; you want to avoid the next stages of hypotension and/or organ failure. Start IV abx, perform bedside I & D, and consult on-call general medicine. Chances are the attendee will come in for this case.

4. You forgot to order medications, but the patient is still okay. Should you tell the patient you forgot?

A good principle to have is to put the patient first. A healthcare provider should take responsibility for their actions by admitting errors. This can reduce the risk of a lawsuit, and builds trust, good rapport, and great communication between the patient and the doctor.

5. What is your stance on euthanasia? Should a patient have a right to die?

The key is to demonstrate your thought process. There are two sides to this position, and you should not position yourself on one side only. Euthanasia helps relieve pain for a terminally ill individual. On the other hand, it is in the act of killing, which is not supported in the medicine system. Take the middle position; for example, you favor euthanasia if the patient is on life support and has the mental capacity to make a decision.

6. You observe a peer medical student cheating. What would you do?

This is unfortunate situation and I think most of us would feel tempted to look the other way . However, I would have to look at the situation objectively, and consider the effects of this person’s behavior. For example, they could harm the curve given on the test, which would lower everyone else’s grade. I would uphold my school’s Honor code and let an administrator know after the exam.

7. How would you tell a patient who was just diagnosed with cancer and only has a few weeks to live?

With the recent results of your studies, I am deeply sorrowed to inform you that you tested positive for ____. This is very unfortunate, sad, and life changing news, but as your doctor I have to tell you what we found, and the options that await for you. The body begins its natural process of slowing down all its functions. It can be emotionally very difficult to watch someone go through these physical changes.What happens in the last days of life is different for everyone. The doctors and nurses looking after the person will check regularly for these changes. They will do all they can to make your relative and yourself as comfortable as possible. Try not to worry that you are going to do something wrong. Just being with your loved one and letting them know you love and care for them is the most important thing right now.

8. How would you express your concern for a child who needs an amputation?

After looking at all viable options, I am deeply sorrowed to inform you that you have high risk to losing your lower leg from this accident/infection. This is very unfortunate and life changing news, but as your doctor I have to tell you what we found, and the options that await for you. We believe than an amputation would be the most appropriate action to save your life. The risk of NOT treating it can cause you to lose our life. I understand that this is hard but we want whats best for you, and from our experience, this would save your life and allow you to continue seeing your friends and family.

9. A 10-year-old child is in for foot examination. You have evidence that the child has been physically and sexually abused, their parent stepped out to take a phone call. How would you respond to this situation?

10.Should physician-assited suicide be allowed in some cases? if no, why? if yes, give example.

11.Could you become involved in a romantic relationship with a patient?

12.Is it ever acceptable to break patient privacy if the patient is harming other?

13.What is your stance on receiving gifts, foods, and perks from reps and/or pharmaceutical companies? Do they influence your medical judgement?

14.Should it be legal for rich people to buy organs for transplant, although they are not on the national database waiting list?