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Ethical issues arise every day in medical care. Medical schools and PA schools frequently like to assess applicants’ positions on various ethical issues during the interview. Ethical questions can come up both as prompts in the multiple mini interview or in the traditional interview. While there are no single right answers with ethical questions, it is always a good idea to show thoughtfulness and to take a position when you are asked to express your opinion about an ethical issue or challenged to explain how you would deal with various ethicalscenarios. In general, it is a good idea to take a middle of the road position when discussing your views. Interviewers tend to look less favorably on extreme positions. As you go about discussing your position or navigating your way through a complex medical ethics scenario during your medical school interview, its useful to have some basic knowledge. Here we review some of the key points that will make you sound more knowledgeable and intelligent for your medical school interview.

Important Medical Ethics Points to Know:

Refusing Medical Treatments

If an adult patient has decision making capacity (is not mentally impaired in a way that affects his ability to make decisions), he is free to refuse medical treatments. This holds true even if the medical treatmentcan save the patient’s life. For example, Jehovah’s Witnesses who possess decision making capacity may refuse to receive a blood transfusion because of their religious views. Religious reasons are not the only reason for refusing treatment. An adult patient with capacity can refuse treatment for any reason. Having said this, parents and guardians cannot refuse a therapy for their child if the therapy has the potential to save the child’s life. This is trueeven if the parent/guardian possesses full mental capacity.

Patient Privacy

A patient’s medical information must be kept completely confidential unless the patient has expressed an intention to harm himself or another person. Confidentially can also be breached if the patient has a communicable disease and a third party is at risk of contracting the communicable disease from the patient. For example, a physician can contact the partner of an HIV positive patient to inform him of his risk of contracting HIV from the patient.

Consent and Privacy for Minors

Patients who are under the age of 18 are considered minors. Minors need to have parental consent to be able to receive a medical treatment. A physician can share a minor’s health information with his parent/guardian. There are a few exceptions to this. First, minors who are financially independent and living alone do not need parental consent and have the right to privacy of their health information. Also for reproductive health, sexual health, and drug abuse issues, a minor’s confidentiality has to be respected. There are some specific issues related to consent/privacy for abortion, and these are discussed below.

Euthanasia

Euthanasia can be considered active or passive. Active euthanasia is when a third party (usually a physician)administers something that ends a patient’s life in the face of a terminal illness. Active euthanasia is illegal in almost all states in the United States. The only exceptions are Oregon, Washington, California, and Vermont. Passive euthanasia is when a life-saving or life-prolonging treatment is withheld,resulting in the death of a patient. Patients can request that life-saving or life-prolonging treatments be withheld. Passive euthanasia is common at the end of life and is considered legal generally speaking. For example, a patient in critical condition with a terminal illness can be withdrawn from a breathing machine, leadingto the patient’s death. For end of life decisions, patients can complete an advanced directive, which is a set of predetermined instructions telling the healthcare staff whether or not to withhold treatments if the patient is incapacitated at the end of life.

Abortion

Abortion laws vary from state to state and may be difficult to keep in mind. Do not worry about remembering all the details. Instead try to develop an overall understanding of the concepts and consider different aspects of the debate surrounding the issue of abortion.

Basic History:

Roe vs. Wade was a United States Supreme Court decision in 1973 that legalized abortion in this country. It states that a women’s decision to have an abortion falls under her right to privacy, which is a constitutional right. Roe vs. Wade does allow states to regulate and restrict a women’s decision in the later stages of pregnancy.

General Laws on Abortion:

• The majority of states require that an abortion be performed by a licensed physician
• The majority of states prohibit abortions after a certain stage in pregnancy (exceptions can be made if the woman’s health is in danger)
• Usually the cutoff point after which an abortion is prohibited is the point of fetal viability
• As a general rule, the fetus is considered viable after 24 weeks of gestation or at the end of the second trimester
• The majority of states allow a physician to refuse to perform an abortion
• Some states require that women receive counseling before undergoing an abortion

Laws on Financing Abortion:

One major aspect of the controversy is whether the government or private insurance agencies should fund abortions. Under federal law, Medicaid must cover the cost of abortion if the pregnancy was caused by rape or incest or if the pregnancy is threatening the life of the woman. Private insurance coverage for abortion depends on the states. Some states restrict private insurance coverage for abortions to specific situations such as rape, incest, and life endangerment.

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Disclaimer: The information provided here is highly simplified. Admissions Helpers or its representatives do not assume any responsibility for how the content used from this article may affect an applicant’s candidacy.