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How To Answer Medical Ethics Questions

Answering medical ethics questions is renowned for being a tricky part of any medical school interview. So, in this blog we hope to allay some of those fears by giving you an ethics toolkit to help you answer any medical ethics question!

With any ethical scenario that you may be presented with in your interview, take the following steps when thinking through your answer:

Define your terms

For instance, if  you’re asked a variant of ‘what do you think about assisted dying?’, make sure you know what assisted dying is. This can be achieved by reading around contemporary medical ethics debates. Tell the interviewer what you understand the term presented in the questions. This shows you have knowledge around the topic of discussion. If however, you get a bit muddled – for example maybe you confuse assisted dying with euthanasia – the interviewer has a chance to put you right! You can then continue on with answering the question, now that the terms have properly been defined.

Think through each of the four pillars of medical ethics

  1. Non-Maleficence
  2. Beneficence
  3. Autonomy
  4. Justice

Use these to formulate your arguments both for and against any question posed to you.

If you are very familiar with certain medical ethics debates, you may be confident just reeling off the main arguments for and against. However, you may find the four pillars useful in order to identify where the crux of the dilemma is. A medical ethics dilemma usually arises when two or more of the pillars of medical ethics are in conflict with one another. For example, in the case of voluntary euthanasia, there is a conflict between the patient’s autonomy (their wish to choose when and how to end their life) and the doctor’s duty to do no harm.

Ensure you give both sides of the argument

You may find it helpful to think about the medical ethics scenario from first the patient’s point of view. Then, consider it from the doctor’s point of view. Finally, consider the scenario from a societal point of view. Whilst you can have your own personal opinion on matters such as abortion and euthanasia, you need to demonstrate that you are able to see both sides of the arguments. So, for this reason, it is best not to jump straight in with your own strong opinion.

Ensure you make it clear that you know the current legal position in the UK

Whilst you understand the medical ethics arguments on both sides, make it clear that you would never act outside of the law. If you are not entirely sure of the legality around the situation, say that you would find out before acting on an ethically demanding case and that you would also check guidelines produced by the GMC (General Medical Council).

When giving your conclusion show that you have weighed up both sides of the argument

You need to come to a well-thought out conclusion. So after you’ve proposed the ‘for’ and ‘against’ arguments, you must take the initiative to indicate on which side you think the stronger arguments lie.

Worked example:

You are working on a care of the elderly ward. Your patient is an 89 year old woman who has been admitted with a chest infection. You have so far been unsuccessful in your treatment with antibiotics and the patient is now refusing any more antibiotics. You know that without them the patient will most likely deteriorate. What are the ethical considerations here?

  1. Define the terms – the key term here is the patient is refusing treatment.
  2. There is a conflict here between the patient’s autonomy and what you as the doctor know will be in their best interests. So there is a conflict between autonomy and beneficence. It could also be argued that going against the patient’s wishes here would cause harm and irrevocably damage the doctor-patient relationship.
  3. The two sides of the argument that need to be weighed up are the patient’s right to autonomy in their medical treatment against the the doctor wanting to treat the patient in their best interests and not cause any further harm.
  4. Patients can legally refuse treatment in the UK.
  5. Another important consideration here is whether the patient is able to make the decision. If the patient’s capacity to make decisions is not impaired then the weight of the argument comes down on the side of patient autonomy- and this is in step with the current legal position in the U.K. Now time to make your decision!

Uploaded by Beth on 23rd December, 2015

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