I need bizarre (humorous) medical ethics situations

Miscellaneous and Personal Stuff I Must Share
1

Some group at our school has started a project called Draw the Line. They put up a bunch of posters with a med school-type ethics situation (guys telling sexist jokes, residents making students fetch dinner, etc.) at the top and space down below where people can write their opinions on the situation in magic marker. It isn’t a bad idea, except that most of the situations either aren’t a big deal or are completely unambiguous.

As the director of this year’s Lampoons, our annual roast of all things medical, I have decided to use this situation to begin the hype by making our own posters. I could still use a few more ethical vignettes, though.

Here’s what I have so far:

  1. Jimmy is scrubbed in on a bypass surgery. As he is holding a clamp on a major artery, the surgeon turns and walks out, saying, “Screw it. I’ll be at the Wheel.”

  2. Richard is in the Urology clinic, preparing to do a prostate exam. He opens the drawer to discover that the exam room is entirely out of lubricant. At the same time, he realizes that the patient is one of his professors from second year.

  3. Eduardo is doing an exam when a very attractive nurse walks into the room. “Is is time for my medicine?” the patient asks. “Oh, it’s always time for this kind of medicine,” the nurse replies, taking off her nurse hat and letting her long blonde hair fall about her shoulders. As she leans over the bed, her low-cut dress straining to hold back her ample cleavage, bad 70’s funk starts playing softly in the background.

  4. You overhear one of the residents threatening to use vulgarity, saying that many people refer to a certain individual as a “bad mother”. When you tell him to shut his mouth, he assures you that he is talkin’ bout Shaft.

Any ideas?
Dr. J

2

The patient really, really needs 50mg of Haldol IM, he’s already bending the rails on the bed where he’s restrained. You prepare to deliver the injection you’ve spent 20 minutes waiting for (it’s after hours, and the Pyxis was down), when you drop the (pre-filled) syringe. It sits, vibrating tip first, imbedded in the cheap linoleum.
Do you pick up the syringe and give the injection anyway?

You are at a large dinner party, and the young lady sitting next to you confides that she’s “a little swollen on the left side: you know, ‘down there’”.
If you take her up on her offer to be ‘examined’, and fail to diagnose a rare vulvular cancer, does your malpractice insurance cover you?

You have a payment due on your Range Rover – and a patient comes into the office who has a large lipoma on his back. He doesn’t really need to have it removed, but he’s a private pay patient, who always pays in cash.
Do you do the procedure?

3

Don’t know if it’s exactly an ethical issue or just general medical awkwardness…but every word is true, nonetheless.

My mom (now deceased) worked as a teacher pre-WWII in a tiny (TINY!) one-room schoolhouse while she and my dad were engaged. It was a country school, in a wide spot in the road, unnamed on all maps.

She married, the war ended, she had 2 kids, divorced, went on to more education, etc.–and 45 years passed, as they tend to do. She got an annoying, chronic bladder/kidney condition that wouldn’t clear up. Her GP referred her to a specialist. Dreading the process but wanting health, she gritted her teeth and went in.

There she was, barely robed, nurse-prodded and humiliatingly recumbant with feet in stirrups. Such fun. The relatively young doc breezed in, sat on the stool and checked out her chart. He chatted a bit then started doing the medical voodoo docs so so well. Mid-exam he popped up like a startled prarie dog over the sheet and chirped, “Hey, you’re Miss X, aren’t you?” (using mom’s long-ago maiden name.)"

Mom, trying to ignore distressing things being done to her nether regions, replied that yes, she WAS Miss X long ago. Turned out the doc was one of her looooong ago elementary students. Which led to a genuinely surreal conversation, mined with either inane or horrendous questions:
“Soooo…you went to medical school, hmmm?”
"How in the world did you recognize me after all these years–and you’re certainly not looking at my face!?"

It says a lot that mom, one of the most modest women that ever lived, LAUGHED over this. And kept going back to the same doc, as the problem proved persistent. Maybe it’s just one of those “doctors are human, too” examples that put medical matters on the kind of matter of fact level they should be anyway.

Anyway, make of it what you will.
Mom, to the end of her days, would lapse into one of her rare smile-evolving-into-helpless-chuckles fits over this.

Veb

4

The only way to save a patient is to consult with a doctor who used unethical means to acquire his knowledge, including torture. Add to the mix the fact that this doctor isn’t the “actual” doctor, but a holographic representation of that doctor.

Oh crap, I’m turning into a Trekie.

5

Not sure if this is an ethical issue, but it was very funny.

I went to my doc (a courtly older gent) for my annual pap. I assumed The Position, and he settled down with his little light and freezing cold speculum. Then said “Well. I didn’t know you had fish down here!”

Brief silence while the nurse looked at him, stunned, and I considered kicking him in the nottinghams for such a crass remark. What next… “Nurse, hand me a net, she’s got a bad case of mackerel.”? :eek:

I have a tattoo of three fish on the inside of my right knee. :smiley:

My SO is a doc. I’ll ask him if he has any contributions to this thread.

6

Not really funny, but a true story that happened to an old nursing instructor of mine. She was assisting with a major abdominal surgery: patient was sliced open from stem to stern. Suddenly, the asbestos ceiling tiles crumbled and large chunks of the ceiling fell directly into the wound. Do you just clean it up as best you can and pretend nothing happened?

Here’s another true story. We noticed that certain residents never washed their hands after using the restroom in the ICU. What do you say? Ummm… you’re a frigging doctor, for heaven’s sake.

Here’s a hilarious true story. A certain aged doctor, who should have retired decades ago, walked into the patient’s hospital room and without preamble, announced “Not only is your diabetes out of control, but the cancer is everywhere. Everywhere, everywhere, everywhere!”, waving his arms about for emphasis. Then, he abruptly left the room. The patient turned to the student nurse (my friend Jeni) and said, “I have diabetes? Oh my God- I have CANCER?!?”

A nurse approached the doctor nervously in the hallway. “Doctor,” she whispered. “That’s not your patient.”

7

Mrs. O is a fount of ethically bizarre situations. One pops to mind, which didn’t involve her but one of her co-workers in a Planned Parenthood in PA:

Patient comes in for an abortion and starts talking with the clinician. Through the ensuing conversation, said clinician finds out the father is her own husband. :eek:

8

Last fall, I came down with a nasty case of laryngitis, sinusitis, and bronchitis. (Basically, my entire respiratory tract was infected.) I was having a hard time breathing, so I went to the ER at the local hospital. The doc saw me, issued her diagnosis, and sent me on my way with antibiotics.

A few days later, I felt worse. I STILL couldn’t talk, (although my husband was grateful for the silence :wink: ) my breathing was worse, and I had chest pain thrown into the mix, on top of a significant amount of coughing up green crap. I went back to the ER.

The admitting nurse began to chew me out in the waiting room, in front of other patients, about how I didn’t take my antibiotics, and now I was back with the same problem, and couldn’t I follow directions?

Suffice it to say, I was shocked. Another nurse took me back to the treatment room, the ER doc chewed the original nurse out and apologized to me, as did the nurse. Her excuse was that she thought I knew she was kidding, and she assumed I had a sense of humor.

Listen, honey, when I’m wheezing and coughing up green crap, I have no sense of humor, OK?

Robin

9

A man is in the Emergency Room with a battery-powered Electric Egg Beater rammed all the way up his rectum. It is still running. The patient is suffering extreme discomfort. He admits to putting it there himself quote–“for shits and giggles” unquote. If you pull it out now, it will cause additional damage.

Do you???

A) Pull it out now, ending his discomfort, & risk the possible extra damage.

             **OR**

B) Gather the rest of the ER staff around you so that they can laugh, point, take photos of the occassion to post on their fridges at home—while you wait for the battery to run down.

Bonus points—is it unethical to give this guy a nickname against his will? And, what would it be?

10

Olentzero, that was hilarious!

True: A coworker of mine was reviewing the x-ray of her critically ill patient and noticed a bright little object lodged in his colon. She puzzled over it for a minute, then touched her ears in horror. One of her earrings was gone, and it looked suspiciously like the object in the poor patient’s belly. Should she take off the other earring, pretend she hadn’t even worn earrings that day, and feign innocence? Or fess up?

Epilogue: we soon discovered the earring wasn’t actually inside the patient, but merely on the bed beneath him. Whew!

11

Not all are that humorous, but might I direct you to a book I edited in 1999? It includes many scenarios of the type I gather you’re looking for (except that they all have to do with the imaging professions).

Towsley-Cook DM, Young TA: Ethical and Legal Issues for Imaging Professionals, St Louis, 1999, Mosby. (ISBN 0815129661)

And does it change things that Crell Moset is quite the hottie and a snappy dresser to boot? :smiley:

Do you live near St. Louis? They just showed that episode in syndication last night. Well, at least Moset did get in the last word–the Feds ARE a bunch of hypocrites.

12

  1. Your anesthesiologist has called in sick on the day you’re scheduled to perform major surgery on the president of an HMO. Do you charge him for the painkillers anyway?

  2. A “doctor” is exposed as having no license and no medical knowledge whatsoever. He’s really a carpenter from New Brunswick. Suddenly, a patient runs into the ER with a 2x4 firmly implanted in his head. The fake doctor looks at you and says “I know I’ve let you down. But you must trust me on this. I’m a damn good carpenter and I can save this man.”

  3. You’re an ER doc at a county hospital. All has been going well for you recently. You’ve just bought a new house, you’re preparing for a wedding with your fiance who’s moved in with you. Suddenly, your life gets torn apart. One of your friends nearly loses his job over a painkiller addiction. Another gets his girlfriend’s house trashed by an ungrateful teenager. Your best friend is nowhere to be seen. Heck, you guys haven’t even talked in years! Your recently pregnant fiance nearly loses her job over a malpractice suit. And you almost die of a brain tumor…but not before crash landing in a helocopter into a junkyard to save the life of a patient. Do you stop and ask yourself what the writers are smoking?

13

(Note- I have next to no knowledge of medical procedure. I apologize for any patently absurd scenarios below.)

  • In the middle of open-heart surgery, the senior surgeon grabs one of the patient’s exposed ribs and asks you to make a wish.

  • You’ve just spent eight hours on the most difficult intestinal surgery you’ve ever had to perform. You notice that your watch seems to be missing.

  • That really annoying waiter from the club you always have lunch in has just been wheeled in to the Emergency Room after having been stabbed thirteen times by yet another irate customer. The nurse shouts at you, “Doctor, can you come to Operating Table #3?”

  • Mr. Jeffries is suffering from a minor stroke, and unless surgery is performed within the next three hours, he’ll die. However, the other three members of your foursome can only wait an hour, and you’re sure that you know just how to approach the chip shot on the 16 this time.

14

One more.

*That beautiful girl with the mountanous breasts who lives three doors down from you gets wheeled into the ER after a massive overdose of heroin. Despite all efforts to revive her, she dies. You get assigned to wheel her down to the empty morgue. Her body is still kind of warm.