AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. January 2005, Volume 7, Number 1.

Module 4

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Case 4.1: Balancing Patient Care and Student Education—Mr. Harvey's Central Line

Option Assessment

A.  

Reminding Mr. Harvey of her status as student and notifying him that she will be placing his central line with Dr. Gage's supervision is preferable and supported by Code Opinion 8.087, "Medical Student Involvement in Patient Care": "Patients should be informed of the identity and training status of individuals involved in their care and all health care professionals share the responsibility for properly identifying themselves."

B.  

Informing Mr. Harvey that she will be performing the procedure without reminding him of her status is acceptable but is not the preferred option. Opinion 8.087, "Medical Student Involvement in Patient Care" states that "Students and their supervisors should refrain from using terms that may be confusing when describing the training status of students." This course of action does not violate this standard, inasmuch as Tina has identified herself as a student, at least once. However, it would be better to remind Mr. Harvey that she is a medical student and then explain that she will place the central line under Dr. Gage's supervision.

C.  

Describing the medical procedure to Mr. Harvey without informing him that Tina will be performing the procedure should be avoided. It violates Code Opinion 8.087, "Medical Student Involvement in Patient Care": "Patients are free to choose from whom they receive treatment." It is important for the roles and activities of each member of the health care team to be clearly explained to the patient. This must be done in advance for patients who will be unconscious during the procedure.

D.  

Informing Mr. Harvey of her past difficulties is acceptable, but it is not required by the Code. Opinion 8.087, "Medical Student Involvement in Patient Care" states that patients "should be informed of the identity and training status of individuals involved in their care." Informing Mr. Harvey that Tina is a medical student fulfills the requirement. Further, Mr. Harvey's safety does not depend on Tina's individual expertise but on the structural expertise arising from the supervision of medical students by residents and attending physicians.

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