If a pharmaceutical company rep offered to bring you and your staff lunch so he or she could spend lunchtime telling you about a brand-new drug, would you accept? A free nice dinner with just you and the rep? Would you accept a trip for your family to go to Italy? How about a Starbucks latte? A pen with the name of the drug on it?
If a doctor yelled at the nurses and a med student for not completing the overnight lab work as ordered because he felt the delay would adversely impact his cancer patient's surgery scheduled for that day, should he be punished for unprofessional behavior and creating a hostile work environment? Or should he be lauded for advocating on behalf of the patient?
If you needed to learn how to perform a pelvic exam, and the young female patient was visibly uncomfortable but didn't specifically request that medical students not be present, would you stay or leave the room? What if you had to perform that exam that week and have it signed off in order to complete your required procedure practice and pass the rotation? What if you later found out she had been raped in the past? If the different scenarios changed your answers, how could you justify them?
If you were a nonreligious surgeon but a seriously ill patient wanted you to pray with herbefore the surgery, would you? What about if the patient asked you to carry a "lucky charm" in your pocket as you performed the surgery? What if you were atheist and actively did not believe in a god?
What would you do with a patient who is elderly, just feels "done" with life, and can't wait to die?
How would you react if you found out your patient was doing or has done illegal drugs?
9 comments:
Let's see how many I get "right"!
1. I'd say, "Sorry, but I can't do that." I wouldn't want to lose my license. Rules are rules, right?
2. a. No. b. No. c. No. d. No. e. No.
3. Neither. The nurses and med student should have done it. The doctor shouldn't have yelled, but (s)he shouldn't be punished unless it has been a pattern of behavior.
4. a. Would it be ok just to ask, "Would you prefer that I leave?" She could be uncomfortable for a variety of reasons, not just due to my presence. If she preferred that I leave or if I felt it was due to my presence, I would leave. b. I would still leave. Doctors should understand that a patient's comfort is more important than having a pelvic exam signed of. There are plenty more pelvic exams out there to be done. "Do no harm."
5. a. Yes, I'd pray with them. b. Yes, I'd keep it in my pocket. c. I'd still pray with them. It doesn't hurt me any, and it would make them feel better.
6. It's not up to me as their doctor to tell them they should keep living. How can I judge their desire to die as wrong? It's their decision. But I would talk to them. Not try and persuade them one way or the other, but just talk to them. See if it's possibly depression, if they could benefit from psych services. Maybe they just need someone to talk to.
7. Treat them as I would any other patient, with the addition of giving them info re: drug rehab programs in the area. If kids were in the home, I'd call CPS.
There is a coal-powered train traveling from Phili to NYC at 60 KPH and another from Boston to NYC at 40 MPH.
Train number one is built out of straw and is slowly (and ironically) burning its cars at a rate of 1 per 20 km. After a car burns off, the train can travel 3 KPH faster, but the heavy heart of the conductor makes him slow down 1 KPH every 30 km. There are 20 cars to begin with.
Train number two is a magic train and can fly for five minute intervals at 75 MPH. This train can only fly when the magic words are said (which happen to be "Waka Maka Peesi"), but these words can only be stated once per hour, and only by the conductor who has a VERY sore throat. The conductor must drink tea before he says the words...and the water for the tea can only be boiled TWICE a day. Each kettle of tea makes 1.5 glasses.
At this rate, would Darron be more likely to legally marry his gay lover once boarding a plane from JFK to SFO after traveling on train 1 or 2?
These ethical dilemmas are very thorny. Maybe they're easy to answer from the armchair, but I bet some of them are tough to actually do in real life.
Would it be unethical to give that McNabster guy a pill and take his computer away? I vote no.
I actually agree with most of Darron's thoughtful answers. What is the difference between a pharm. rep telling you about a new drug and a seminar put on by the same company? How do doctors/pharmacists learn about and ask questions regarding new drugs?
When a pharm rep tells you personally about something, you generally get better food and more personal attention. Doctors learn about new drugs by cavorting with the hot drug reps, of course.
"Would it be unethical to give that McNabster guy a pill and take his computer away? I vote no."
"McNabster Guy" -- Don't go flattering me and make sound like a superhero. What would "McNabster Guy's" super power be? The ability to steal music at McDonalds.
Also, I don't know why you would give me a pill and then take my computer away...Honestly, that doesn't seem to make a lot of sense. Of course, anyone who starts a sentence with "I actually agree with most of Darron's thoughtful answers" obviously has some judgment issues to work on.
I actually think you are trying to distract people from the fact that you can't figure out a simple math problem. Here is a hint: The answer was train 2.
As it has always seemed to me, when dealing with ethical questions, there is a small white area, a comparably small black area, and an immensely huge gray area. Or as Thelma would have said: "Do what's right".
Whatever he likes to call himself, someone please give him a pill-one preferable one that will relive him of all that gas.
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