Dr Jonathan Treem joins Ethics Talk to discuss his article, coauthored with Drs Joel Yager and Jennifer L. Gaudiani: “A Life-Affirming Palliative Care Model for Severe and Enduring Anorexia Nervosa.”
The eradication of hazing has not diminished the socialization, camaraderie, or commitment of new recruits. The physical, emotional, and mental demands of basic training suffice to produce the outcomes previously ascribed to hazing.
Requirements for informed consent are relatively vague and the exceptions are few, so it is in the physician’s best interest to inform patients about proposed treatment options, ascertain that they understand their choices, and secure their consent.
Medical school faculty have a nonnegotiable duty to report students whose professional behavior falls seriously short of the mark. If they refrain from fulfilling this duty for fear of retaliation, the antiharassment pendulum has truly swung too far.
The gross negligence of the physicians who cared for Steve Biko, an apartheid-era South African political activist who died of injuries inflicted while in police custody, illustrates how dual loyalty—toward patients and, in this case, the state—makes performance of professional duties difficult.
AMA J Ethics. 2015;17(10):966-972. doi:
10.1001/journalofethics.2015.17.10.mhst1-1510.
It is the clerkship director's role to advise students labeled gunners when their behavior becomes a problem, but changes in the larger system might help to prevent this behavior from occurring in the first place.
The ambiguity about and lack of uniformity in informed consent practices does not lend itself to the kind of shield from malpractice liability that exists in some more concrete, standardizable aspects of medical practice.
Role-playing exercises, which help participants understand the experience of being harassed, can be helpful in addressing mistreatment in medical education.