Friday, August 22, 2008

P.R.O.D.-the new club on campus

Ok, so week two is done. I am actually leaving school an hour earlier than I had planned. Why, you might ask? (I pretty much sat here for the last five minutes trying to come up with a witty response, but I could not.) I guess that kind of tells you why I am leaving early. I feel like if I try to learn/read/stare/listen to another thing I will forget the way home, which would result in me A)sleeping at school B)sleeping under a bridge C)hanging out with someone in the area who might rob me or D)all of the above. Which brings me to my next point.

I had an epiphany last night. Why on earth would someone try to rob a medical student? We are actually some of the most indebted students around. We are the outlier to the bell curve of debt, and I am talking the numbers in the red. If anyone should be doing the robbing, it should be US! In fact, maybe I can get that club approved here on campus. P.R.O.D. Proactive Rapid Olbigation Dispursement. That doesn't sound so bad.

So this week was filled with 1 clinical lecture, 1 embryology lecture, 6 microbiology lectures, 2 histology, 5 immunology, 2 physiology, 1 bioethics, and 3 pathology lectures. Then 3 labs. The pathology professor is good. He wants us to learn and is quite entertaining. He shows some interesting slides as well as MANY that elicit an "ooooo" or "ouch" response. We also spent 2 hours in a room looking at x-rays and other various scans, which brings me to my specialty hierarchy. As you may have noticed, I have added Aerospace Medicine and dropped some down a little bit. I think Aerospace medicine would be very interesting. I have read a few articles on it and will try to learn more about it when I can.

Finally, I added a small question below. I am interested in what my small handful of readers think about the medical ethics question that was presented in class to us. (PLEASE TYPE YOUR ANSWER IN AS A COMMENT IF YOU WISH TO DO SO.) I think it is really interesting stuff. Makes you think hard. Oh, and YES there is a "correct" answer, which led me to ask the following question during our discussion this week. "What makes the ethics board so special that they get to decide what is the ethical thing to do?I mean, you could have ten ethics boards from ten hospitals all give different decisions, right?" I wasn't trying to be a smart-ass, just trying to figure out how there could be one right answer.

This situation came up in a major transplant program which does more kidney transplants than anyone in the U.S. In brief: An adult son who was willing to be a live kidney donor for his father is found in testing that he is not biologically related to his father. Neither the father nor the son appear to know this. Should they be told? If so, what should be said, by whom, to whom-and why? If not, why not- and what should be disclosed?


  1. I cannot see the question, which bums me out for so many reasons:
    1. I was raised Catholic and ALWAYS wondered why the Pope--a single man with no children--got to tell everyone that they couldn't use birth control.
    2. I used to consider myself very ethical and then realized that I was just really judgmental...
    3. It's Friday night at 7:30 and I have absolutely nothing to do. The thought of answering your question was the most exciting part of my day.
    I'll check back later.
    I am sure I have a GREAT and really powerful answer which you may want to use to impress your professors.
    Or the Pope.

  2. To answer the question posed:
    Neither party should be told anything about paternity in this case. That is not an ethical decision, merely a moral one. Ethically, it would suffice to tell the son that he was not a match for his father. No higher purpose would be served through conveying the paternity information, and the stress of this knowledge might put the father's health in jeopardy.
    Now for my erudite (?) treatise which you, as a busy med student might skip:
    I think you were wise to ask the question of the professor. With stem cell research being argued, it is valid to question prevailing autocracies. There is no one absolute ethics power (thank God), and these topics are constantly in flux as more scientific information is discovered and as moral standards adapt. I believe any ethics board would only be empowered to make its decision based on the current beliefs and practices of the institution which they serve. Those beliefs and practices might be determined as much by economic factors as by patient welfare. History has seen many ethics doctrines fall along the way. Years ago, a woman whose life was in jeopardy while giving birth, would have been forced to die to save her baby if she gave birth in a Roman Catholic hospital. In a Protestant one, that would not have been the case. What about abortion rights? We have certainly seen the evolution of those arguments; women no longer need to go to Mexico or Sweden (at least for now) and yet the question of when life begins is still being argued by our Presidential candidates.
    In summary, ethics are not an absolute, any more than there is one absolute path to heaven. A parallel definitely exists here. Too many subtleties exist for an absolute.

    Can't wait to read the right" answer!

  3. I've been thinking over the question for a couple of days now. At first I thought along the same lines as your one needs to know about the paternity issue--that would cause more trouble in the long run.
    But the more I thought about it, the more I thought of what a lie that whole family was leading. The mother/wife probably knew all along that the man was not her baby's (biological) father. The father may have known too. So, this young man has NEVER truly known his family history. He has no idea if there is cancer or diabetes or anything else in HIS family. Is it ethical to let him go on thinking that his health history is something it is not?
    I have a cousin who is not her dad's biological child. My mother 'slipped' and told me once. This cousin is 32 years old now and just had her 3rd child and was quite sick through the pregnancy. Is it fair that she doesn't know what possible health issues she MIGHT have?
    In all honesty, I would not want to be the one to tell her (or to confront your hypothetical family) but I do believe that honesty can bring clarity and--in the long run--is the best policy.
    OK...back to Edward and Bella in Twilight. I am glad I am reading novels and leaving the medical journals to you.
    You will be such a good doctor.

  4. As a nurse working trauma/critical care we say nothing but no match.Only if we are pressed will we say anything else and no one ever presses.