The practice of medicine is full of ethical issues and challenges. How should a medical professional respond when he encounters ethical breaches by his own colleagues?
In a survey performed by six Pennsylvania Medical Schools, 98% of third and fourth year medical students report hearing physicians refer to their patients in a derogatory manner, and 61% report witnessing unethical incidents such as unnecessary practice procedures – performed on patients without prior consent – or the administration of drugs amidst patient refusal. Actions such as these are in direct conflict with the Code of Medical Ethics put forth by the American Medical Association that clearly dictates that patients have the right to courtesy, respect, and to make decisions regarding their own healthcare.
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When issues such as these arise, the response on part of the observing medical professional can be unclear due to power differential. Is a medical student- or even a resident- ethically obliged to report on the unethical behavior of an attending or a superior- considering the potential or even the perceived personal risk involved for him and his reputation?
Wilson is a hypothetical fourth year medical student introduced to us by the AMA’s Journal of Ethics who finds himself in the midst of such a situation while on his surgery rotation with Dr. Cartwright, also a hypothetical renowned trauma surgeon. Dr. Cartwright carries a reputation of being difficult to work with. He is critical, demanding and openly rude to his colleagues. Wilson feels helpless and distraught.
In such a situation, direct confrontation with Dr. Cartwright can prove detrimental to Wilson and is unlikely to change Dr. Cartwright’s behavior. However, since all medical schools are required by the Liaison Committee on Medical Education (LCME) to have set policies and procedures to battle mistreatment, medical schools are mandated to have “a safe outlet and a point person to help students handle such situations,” and approaching this point person anonymously or by requesting confidentiality will allow students in similar circumstances as Wilson to appropriately resolve the situation.
Unethical Conduct and Abuse is a serious issue in healthcare today, and it must be properly addressed. If it undermines the quality of a patient’s care and of the doctor-patient relationship, then it does deserve our attention and must not be considered lightly.
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