Decisions made at the end of life are among the most complicated.
M1 Jeff, M3 Ananya, and MD/PhD students Riley and Miranda discuss what they’re taught about the ethics surrounding the end of life.
What are the physician’s responsibilities? How do they balance the patient’s wishes, the family’s desires, the directive to do no harm and to provide the best possible care, and the need to ensure that such considerations are supplied to any and all patients.
Add in the myriad cultural and religious beliefs that doctors, patients, and families have, and you get quite a difficult set of calculations to ponder.
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Cultural competency is a tough thing to teach, but so important. Today’s physician (and med students!) encounter patients from wide range of backgrounds, any of which could come into play in a patient-provider interaction. In this episode, Brent asks how med students learn about the nuances that come with treating people of different backgrounds, from ethnicity to gender to religion to disability. Aline Sandouk and Brady Campbell consider the question and offer their experiences.
And Brady, who’s co-hosting on the eve of leaving CCOM for a year-long Masters in Public Health program at Hopkins, talks about why he’s pursuing a whole ‘nother degree and why he’s decided Hopkins is the right place for that given that we have a lovely Public Health school right next door.
Dr. Paul Farmer is sort of the rock god of global health. He’s an incredibly busy and influential guy, so when he flew in from Liberia to spend the entire day here with us at the Carver College of Medicine, it wasn’t easy to keep the stars from our eyes. Of course, he’s a physician, but he’s also a medical anthropologist, chief of Brigham and Women’s Division of Global Health Equity, professor of medicine at Harvard, and the UN Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti. One of the things you notice about Dr. Farmer is that although he’s clearly a celebrity in his field, it doesn’t dampen his enthusiasm, idealism, and the pleasure he takes in meeting students who share his passion for understanding and changing how healthcare is delivered to the world’s neediest people. Continue reading Dr. Paul Farmer and Liberation Medicine→
You’ve practiced how to extract from a patient their chief complaint. You’ve memorized lists (and lists and lists) of drugs, treatment modalities, and other interventions. You’ve learned all the physical exam skills on the test, and you’ve got every organ system down pat. You even remember the Kreb’s cycle.
Now, your patient has walked into the exam room looking for help with her headache (although she turns out to have none), doesn’t appreciate your blank stare when she says her soul is lost, and is very confused about why you’re treating her clearly ‘hot’ illness with a ‘hot’ medicine. Time for a psych consult?
Nope. Time to delve into the patient’s cultural beliefs about illness, treatment, and doctors, and reach some sort of understanding between you and your patient that allows for a good outcome. That’s what cultural psychiatrist Hendry Ton, the Medical Director of the Transcultural Wellness Center and Director of Education at UC Davis School of Medicine Center for Reducing Health Disparities, advised UI student Lisa Wehr to do when she encounters a patient whose beliefs just don’t line up with those taught by Western medicine.
Recommended: National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care