Phillipa J Malpas1, Warwick Bagg2, Jill Yielder3, Alan F Merry4. 1. Assoc Prof in Clinical Medical Ethics, Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland. 2. Professor of Medicine, Head of the Medical Programme, Faculty of Medical and Health Sciences Administration, University of Auckland, Auckland; Endocrinologist, Greenlane Clinical Centre, ADHB. 3. Senior Lecturer, Medical Programme Directorate, Faculty of Medical and Health Sciences, University of Auckland, Auckland. 4. Head of School, School of Medicine, University of Auckland, Auckland; Specialist Anaesthetist, Auckland City Hospital, Auckland District Health Board, Auckland.
Abstract
AIM: We set out to explore the question, what ethical challenges do medical students identify when asked to perform or observe a sensitive examination, given a historical background relevant to this context. METHOD: Thematic analysis of 21 Ethics Reports from 9 female and 12 male students. RESULTS: Overall 14 students undertook a sensitive examination without the patient's consent; three did not carry out a sensitive examination because of a lack of consent; and two students (or their senior colleagues) gained the patient's written consent for the student to undertake the examination. One patient refused the student's request for consent to perform a digital rectal examination; and in the final case, verbal consent was given by the patient for the student to observe a bimanual examination only. Three interrelated core themes arose from thematic analysis of the research question: systemic constraints on getting consent; internal conflicts of interest; and, power and hierarchy. CONCLUSIONS: A number of senior medical students at our institution disclosed observing or performing sensitive examinations on patients without the patients' knowledge or consent.
AIM: We set out to explore the question, what ethical challenges do medical students identify when asked to perform or observe a sensitive examination, given a historical background relevant to this context. METHOD: Thematic analysis of 21 Ethics Reports from 9 female and 12 male students. RESULTS: Overall 14 students undertook a sensitive examination without the patient's consent; three did not carry out a sensitive examination because of a lack of consent; and two students (or their senior colleagues) gained the patient's written consent for the student to undertake the examination. One patient refused the student's request for consent to perform a digital rectal examination; and in the final case, verbal consent was given by the patient for the student to observe a bimanual examination only. Three interrelated core themes arose from thematic analysis of the research question: systemic constraints on getting consent; internal conflicts of interest; and, power and hierarchy. CONCLUSIONS: A number of senior medical students at our institution disclosed observing or performing sensitive examinations on patients without the patients' knowledge or consent.
Authors: Alberto Álvarez Terán; Camilo Palazuelos; Trinidad Dierssen-Sotos; Jessica Alonso-Molero; Javier Llorca; Inés Gómez-Acebo Journal: Int J Environ Res Public Health Date: 2022-09-04 Impact factor: 4.614