Clinical Skills – Ethics/Humanities/Health Law
Tutorial
Notes for
10-10:50
This session takes place the day after the fourth simulated patient session. However, while that should probably be the main topic of discussion, there are a number of other points that could be covered, as outlined below. For various reasons, we haven’t had a group discussion with them since the first clinical skills case. I’ve attached a copy of cases 3 & 4, along with some notes on ethical aspects of the case that were prepared by Daryl Pullman. (We’ll leave case 2 aside for now.)
Case four raises a number of difficult issues we haven’t touched on yet, primarily concerning abortion, parental decision making, sterilization of the mentally handicapped and general attitudes towards the mentally handicapped. Daryl’s notes do a nice of job summarizing these issues. No doubt it will be impossible to adequately discuss all these issues in a fifty minute session. Probably it’s best just to let the student discussion shape the issues you cover.
Case three primarily raises concerning confidentiality and the duty to warn others about infectious conditions. To some extent these issues were covered in the discussion of clinical skills case #1, although here the patient is an adult, not a minor.
In addition to the issues raised by the cases, you might want to discuss a guest lecture the students saw early last week. The talk was by Jeff Blackwood and focused on what the public expects of medical doctors. He spent a considerable amount of time talking about the need for patients to take control of their own healthcare, and particularly for patients to not take what their doctors tell them at face value. In general, he seemed to be someone who would be a very demanding patient. Having talked to some of the students since then, there were very different reactions to the talk (ranging from horror and indignation to strong support). While I know not all of us were at the talk, it should be easy to get a discussion going simply by asking a student to recap the talk briefly and then asking the group what they thought of it. Depending on how eager your group is to talk about the issues raised by case 4, it might be useful to spend 20 minutes or so letting them discuss their reactions to the talk.
Regardless of whether you stick to the Clinical Skills cases or discuss the guest lecture, it would be helpful if you could spend at least some of the session applying the facts, principles, concepts approach that the students have been introduced to in class. Often this will be a good way to start a discussion about the case. (Daryl’s notes for the Clinical Skills case provide a good example of this approach.)
Thanks for doing this. If you have any questions or concerns, you can reach me at 777-6720 or alatus@mun.ca
Andrew