Interview Question Time 3#

Discussion in 'Interviews' started by DrChopper, Oct 21, 2012.

  1. frootloop

    frootloop D-D-D-Doctor Moderator

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    This doesn't contradict what I said, rather confirms it. Once you've already started caring for someone, you assume a duty of care. If you just casually stroll on past, you're fine (legally).
     
  2. Dsquall

    Dsquall Regular Member

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    Yeah, should have probably said I didn't disagree with you, but i'd add that it doesn't have to be 'treatment', simply picking someone up or something along those lines, as long as it deprives them of an opportunity for proper help is sufficient.
     
  3. DanNQ

    DanNQ New Member

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    That's not true. A SFA course only gives you the skills and abilities to respond to an emergency situation, it doesn't legally bind you to performing first aid on anybody. I'm not sure about the higher level first aid qualifications as I haven't done them, nor have I looked into them, but I imagine they'd be the same unless they're being used for employment.

    Regardless of if you have any first aid qualifications, and has already been stated, the moment you commence any kind of first aid you're responsible for the care of that person. Although, that isn't the case if they tell you they don't need or want your assistance.
     
  4. DrChopper

    DrChopper Regular Member

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    Fair enough, I'm not claiming to know the legal issues behind this, i'm merely re-iterating what I got told. I'm not sure what the SFA course is but i just checked the the course code for the one I did was HLTFA301C apparently this roughly translates to first aid level two with CPR.
     
  5. Havox

    Havox Sword and Martini Guy! Emeritus

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    [video=youtube;f_lRg8MsB0k]http://www.youtube.com/watch?v=f_lRg8MsB0k[/video]

    Designated first aider is completely different, you've assumed duty of care already. A passer by doesn't need to do sh*t.
     
  6. geeoftee

    geeoftee Regular Member

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    With respect to duty of care and passers-by please remember that different states have different laws/criminal codes regarding this. All states don't have a duty to rescue clause in their various legal statutes and I know that QLD also has a good Samaritan clause whereby first aiders are exempt from facing legal proceedings so long as the care provided was done in good faith with reasonable skill (not grossly negligent). However, NT has a clause whereby all passersby have a legal responsibility to help out in first aid situations as callously failing to lend first aid is a criminal offense. Also remember that just because you dont have a legal responsibility that doesnt mean you dont also have an ethical or professional responsibility. I dont know if Good Medical Practice or the AMA Code of Ethics has any guidelines on the ethics of providing first aid as a medical student but I feel it wouldnt go down too well if you simply ignored a first aid case.
     
  7. DrChopper

    DrChopper Regular Member

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    Well there you go, learn something new everyday!
     
  8. DanNQ

    DanNQ New Member

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    I know. :)
    SFA is the Senior First Aid course (HLTFA301C), SFA is just an acronym that gets used from time to time.
    As far as I was aware providing medical assistance is now a requirement, considering the States passed legislation to protect practitioners whom are not negligent when providing medical assistance?
     
  9. will22

    will22 Regular Member

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    But the thing is who would ever know if a medical practitioner simply walked by a person in a medical emergency and decided not to intervene. Duty of care is established when the practitioners action (or inaction) will have a reasonably foreseeable effect on the patient. So technically it could be argued that a duty of care is established when a practitioner observes a person in need of medical assistance, but the law is explicit about there being no obligation to stop and assist (in Vic). There is no precedence for a 'Good Samaritan' ever been found guilty of negligence (even when the four elements are present) in common law and there is even protections from any legal actions against Good Samaritans in statutory law (in Vic), so really there are no legal implications of doing the ethical and moral thing.
     
  10. Fifty shades

    Fifty shades Regular Member

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    Hole
    ly
    crap
    As Alex Llloyd once wrote, "youuuuuuu are aamazing" , these response appear to be well and truly amazing and i am thoroughly impressed. If this is my competition i really must practice articulating myself more. Oh well got about 3 weeks after exams (including schoolies) so there is still time :D, good luck to all interviewee's. :D
     
  11. DrChopper

    DrChopper Regular Member

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    I'm not 100% and most of this knowledge I left when I left legal studies but I think what your talking about here is civil litigation? To be sued for negligence, under the negligence tort, three elements have to be proven; the duty of care needs to be established, needs to be directly broken and damage needs to be sustained as a direct result. So even as a medical practitioner apart from morality is there really nothing that obligation duty of care?
    Though I've have no idea of the criminal liability in regards to this issue, if anyone else does please share!
     
  12. will22

    will22 Regular Member

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    Yeh I'm talking civil negligence but criminal negligence has the same elements, however they must be proven beyond reasonable doubt rather than on the balance of probabilities. Criminal negligence only comes into it if you do something grossly negligent and there is an aspect of malice to it (unlikely as a 'good samaritan'). Negligence has 4 elements: (1)Duty of care, (2) Breach of Duty of Care, (3)Damage caused and (4) the damaged cause was 'reasonably foreseeable'.
     
  13. Havox

    Havox Sword and Martini Guy! Emeritus

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    Sigh. Let's make a few things perfectly clear. A first aider is NOT a medical practitioner and as such is NOT subject to the same legislation. A first aider acting in good faith CANNOT be sued for negligence under the Good Samaritan act by law if something happens under their duty of care. HOWEVER, a licenced medical practitioner (a doctor) if identified and has undertaken the responsibility of looking after the casualty must act within reasonable limits of modern medicine otherwise they can be sued for negligence. These two groups are not the same thing. Second thing to point out is that a First Aider is not obliged to help a casualty, a medical practitioner, is required by law to stop and render assistance in NSW and Vic (check your state laws on this for differences) and is required to identify themselves to paramedics if they've already arrived.
     
    Last edited: Nov 6, 2012
  14. Russ

    Russ Regular Member

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    Well if you want to get this back on track, this is a question I was asked in a USyd interview (no disclosure agreement signed fyi)

    A couple, who are good family friends of yours, come to you asking your advice as a doctor about their infant son. They are considering circumcision but are unsure about whether or not it will be beneficial, especially as they are concerned about the risks involved in this procedure.
    What communication skills do you think are important for this situation?
    How would you structure your response to the couple?
     
  15. DanNQ

    DanNQ New Member

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    Depends on the circumstances.

    Did they come to me as a client/patient or did they come to me as a friend?

    If they came to me as a friend, then I couldn't provide advice due to ethical and legal reasons. If I provide advice I could be held liable for advising them to make their decision, of which, complications may arise, and in that instance insurance won't cover me and I could end up in deep shit. Best I could do is carefully discuss the risks but not advise them on which decision to make. If the pressed me for an answer I would suggest they consult their family/regular GP, or better yet, their pediatrician.

    If they came to me as a client/patient, I would discuss the risks and possible outcomes of both choices and whether it is a necessity. My honest advice would be to avoid circumcision except in the instance where it is required for medical purposes (extreme case of phimosis would be one example). Basically, if it isn't broken, leave it alone! And as above, I would suggest they consult their family/regular GP and/or their pediatrician.

    Another question: Are they doing it for religious/spiritual reasons?

    I can't discriminate against religious/spiritual reasons for the procedure, but that doesn't mean I need to advise them to do it either. As with above, I would discuss the risks/outcomes and still advise them to leave it unless circumcision was medically necessary.

    All in all, as a doctor, and in this particular case, I can only advise, not instruct, so the best I can do is be helpful and provide as much information possible without discriminating.
     
  16. DrChopper

    DrChopper Regular Member

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    I wouldn't make any assumptions regarding their decision and views. I'd ensure that I've asked them all the sufficient information as by way of motives and reasoning. Once that is done I would explain to them that it is wholly their choice and that I was simply providing them with the positives and negatives of each option and tell them that I cannot offer any direction as to what they should do, its a personal choice and it would not be my place to advocate one method over another. As for important skills i'm not really sure, i'd just suggest keeping your position and role in mind. Also I agree with DanQ in that it is very subjective in regards to the way in which they are approaching me, as a doctor or as a friend. This of course would alter my response.

    PS. Once this question is discussed for a little while longer I'll post the next one.

    DrC
     
  17. padraic

    padraic New Member

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    As a medical practitioner, my first action would be to do the appropriate background research on circumcision, especially with regards to the benefits, risk and evidence-based findings behind the procedure. I would communicate this information via a simpler pros-vs-cons format to the couple, and make sure they understood its outcomes fully, answering any queries they may have. Once I am sure that they are sufficiently informed, I state that the final decision ultimately lies with them (as part of the autonomy each patient, or parents of underage patients, is granted).

    The most important factors in making this a successful discussion is making sure that there is understanding of the procedure and that dialogue pertaining to any concern is encouraged, so that the patient feels informed and more confident in their decision. Sensitivity to any cultural, religious or social factors which may come into play (which is common when circumcision is involved) must also be maintained. And finally, emphasis on the patient's autonomy and full acknowledgement of their decision-making power should be highlighted towards the end of the discussion.
     
  18. cheerishgirl96

    cheerishgirl96 New Member

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    The thing that caught my attention when i first saw this is "phimosis." Hey, is this for an undergraduate interview? I mean for the study after leaving highschool? Is it only me who doesnt know the word phimosis :unsure:
     
  19. Jordan

    Jordan Regular Member

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    Just a friendly reminder that the interview blackout is still in place until the end of January. Talking about hypothetical questions you come up with by yourself is ok but be very careful to not use questions which have actually come out of interviews - even if you've slightly modified them.

    As always, best of luck to everyone for your interviews!
     
  20. Leve7y

    Leve7y New Member

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    not really an MMI question, but a tough ethical reasoning question nonetheless that i have problems with



    So i've come across a ethical reasoning problem that really has me stumped


    Justice: What&#39s The Right Thing To Do? Episode 01 "THE MORAL SIDE OF MURDER" - YouTube


    It's a very long video so i'll summarise


    (unlikely to directly come up on MMI, but trying to expand my critical reasoning).


    Essentially:
    Let's say a cart has 2 paths, and either you can let the cart go down it's current path and kill 10 people, or you can change the cart of the path and kill 2 people.
    Personally, and i know some people will disagree with me, i'd change the path of the cart, because surely you want to ensure the best outcomes for as many people as possible. This was the general consensus amongst the students in the uni lecture IIRC.


    However,
    If the scenario is changed to: You're a medical practitioner and a person is unconscious and may die, but if you take his organs out now, you can save 20 other people who would die if you didn't.




    For the second scenario i'm extremely uncomfortable trying to justify killing the person because in practice that's something society has taught us would be horrible and disgusting, however i'm not sure logically, rationally of the difference so if this came up in the interview i'd struggle to justify my different approach to scenario 1 and the modified scenario,
    any thoughts?




    (note it's been a while since i watched the whole thing, my specific memory will be fuzzy)
     

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