Students at Prairie High School were faced with all sorts of medical ethics dilemmas last week.
Forcibly treat a woman in respiratory distress or allow her to die comfortably? Respect the beliefs of a culture or treat a woman who has cancer? Make a woman with an abdominal aneurism have surgery or allow it to rupture and kill her?
Luckily for the students, the life-or-death scenarios had already been resolved by licensed physicians. Dr. John Koehler, a family practitioner at Legacy Health’s Battle Ground clinic, shared the case studies with high school sophomores, juniors and seniors interested in health care careers.
Shari Pfeiffer, a registered nurse who teaches the health sciences careers course, invited Koehler for the discussion in medical ethics. She wanted to provoke critical thinking among her students.
“It’s bringing up topics for them,” Pfeiffer said. “It is a hard subject, especially for high school students. A lot of people don’t talk about it.”
But for one hour last week, students in three of Pfeiffer’s classes did discuss medical ethics and the patient bill of rights.
To tell or not to tell
One case study involved a 78-year-old Laotian woman with cancer. The woman’s family asked Koehler (then a medical student) to treat the disease but not tell the woman she had cancer. In Laotian culture, people are not told if they have terminal cancer because many believe knowing death is coming makes the suffering worse.
Koehler posed the dilemma to the students.
“What do you do?” he asked.
The class was split.
“I think it’s the patient’s right to know,” 17-year-old Talia Perrins said.
“I wouldn’t tell her,” 17-year-old David Swan countered. “It’s her culture. It’s what she’s grown up believing.”
Koehler told the family he wouldn’t tell the woman that day that she had cancer, but he also would not treat the cancer without her knowing the diagnosis. He also told the woman’s family to talk to her about her health. He then spoke to the woman about her beliefs and culture and asked her to come back a couple days later, when he told her she had cancer. She made the decision to undergo chemotherapy treatment and fight the cancer, Koehler said.
Providing medical care doesn’t always have to be black or white, he told the students.
“There’s stuff you can do behind the scenes,” Koehler said. “That’s the beauty of being a doctor.”
Koehler was one of the dozens of guest speakers the students will hear from throughout the year. The health science careers course at Prairie examines 200 to 300 medical careers, all of which require ethical decision-making at some point, Pfeiffer said.
“Thinking about it at this stage is extremely important,” said Pfeiffer, adding that all medical schools ask questions about ethics during the application process.
Many of the students offered their thoughts on what would be the ethical decision during the class discussion. In most cases, the students were conflicted by their desire to treat an ill person and the patient’s right to choose, or deny, their care.
“Sometimes there’s not a clear-cut option,” Koehler told the students. “That’s why medical ethics exist.”
Marissa Harshman: http://twitter.com/col_health; http://facebook.com/reporterharshman; marissa.harshman@columbian.com; 360-735-4546.
