Medical Ethics in one minute, not one day

- Ask the patient if it's ok before you stick a camera up their arse. It also kinda helps if you tell them why you have to do it.
- Make sure the patient can rationally decide for themselves without coercing their decision-making process. Coercing is bad. Paedophiles coerce little children. Do I really need to say more?
- If jabbing someone with a needle for the purpose of research, it only works if the said needle doesn't contain a flesh eating virus disguised as 'a potentially new drug treatment'

- Try and make the patient walk out of your room feeling better. That's kinda the whole point of this medicine thing..... in case you haven't yet figured out why you're here.
- You're holding a mini ninja blade otherwise known as a scalpel. Note that it is not a killing tool.
- When the patient walks out of the room, don't tell the world about their rapidly growing list of STIs. It may be amusing to you, but probably not as amusing as it is for their lawyer.

The end.

Weekend.

Medical Law

Friday morning again. Law all over again. Hardly anyone's paid attention again. About half of the class has turned up to the tute. You know what? I've actually taken quite a bit away from these law sessions (seriously!!!) So, it's time to revise. Let's revise the key issues regarding medical law, and the best way to stop them from threatening your career.

By the way, a disclaimer: If you are reading this years after it has been posted, and you are the legal practitioner of a client who is currently suing me for something, then please note that all this is not to be taken seriously. I repeat: I AM JUST JOKING! Also, if you are a medical student reading this, and you do decide to take this seriously, YOU DESERVE TO HAVE SOMEONE SUE THE PANTS OFF YOU, YOU DOUCHE. AND IF YOU ARE READING THIS WHILE CLASS IS GOING ON, THEN STOP READING AND START LISTENING!

Key Medical Issues

Mistaking Left vs Right

We've all done it - mistake the left for the right or the right for the left. Hell, I did it during my driving test all those years ago. If I can turn left when some guy asks me to go right, imagine what I could do with an orthopaedic drill, a bone chisel, and a human body that's been anaesthetised! Such a tragedy can be easily avoided with a thick, black permanent marker. When that poor sucker that's going under the knife walks in, don't shake hands or say hi to him/her. There are more important things to be done first. Get the marker out and draw a giant star on whichever leg needs to be operated on. You can even be creative and draw or write something on there. "Say goodbye to this leg" is not recommended.

Confidentiality

What goes on in the consult room, stays in the consult room. You wouldn't want your doctor disclosing your current STI track record would you? Confidentiality is like the house sewerage pipes - break it, and you're in deep shit. You can omit names, but the world is tiny. If you mention "a 56 year old female", chances are, some guy 400 metres away will hear you and know exactly who you're talking about. Avoiding this is pretty simple - just shut the hell up in public. But what about those "secure" medical records? They always ends up in the wrong hands. So what do you do? Do what the crims do. Burn the evidence. At the end of every consult, take those notes you've been writing diligently and burn them in front of your patient's eyes. Nothing says "it's OK. Your secret's safe with me" better than burning paper.

Medical Negligence

Negligence is the technical legal term for "a huge cock-up". There are endless ways of achieving this. Such ways include administering the wrong drug, letting the patient fall and fracture a hip when you get them out of bed, injecting into a vein when you're not supposed to, and somehow causing someone to go blind when you're inserting a scope up their rectum. Best way to avoid such cock-ups? Five words: Let the nurses do it. Face it, future and current doctors. You might be there to make the decisions and boss people around, but when it comes to "hands on" work, you have as much dexterity as a seven month old baby. The nurses completely own you on most procedural work, so just admit your shortfalls and let them do it. It's not being lazy, it's called "doing what's best for your patient". The plus side is, if something goes wrong, the lawyers won't be coming after you. Win!

Relationships with clients

Falling in love with your patient is a huge no-no. No matter how hot your patient is, no girl is worth your medical career. (Exceptions to this rule can be found here, here, and here.) It's hard to avoid such feelings though. You're stuck in a small room all day, and you meet so many people. And with all that stress you're exposed to, it's hard to keep those emotions in check. You need reminders. And what better reminder than a picture of your significant other. Plaster her picture everywhere in your consult room, but that picture shouldn't be one of her smiling or else it's like she's saying "go on, I approve of your infidelity!" No, those pictures should have her looking at you with an angry "if you cheat on me, I'm going to take away most of your money" face. That should be enough to stop you from cheating on her.

Sexual assault

The sexual assault lawsuit is complicated. Well, for males at least. When a male doctor does something unlawful with a female patient, then that lady will rightfully see it as sexual assault. Yet when a female doctor does something unlawful with a male patient, then that guy will usually see it as a fantasy coming true. Regardless of such gender differences, sexual assault is indeed a very serious issue. There is, however, one major problem with tackling this subject. You see, there is just no way around it. I don't know about you, but you can give me all the warning you want. It still won't make a finger up the anus, a poke of my breast, or an alarmingly-thicker-than-the-hole-it's-supposed-to-go-into sized tube up the urethra any less traumatic. Face it, men. There is one absolute with becoming a doctor in today's litigation happy Western society: You are eventually going to get sued for sexual assault at some time. It doesn't matter how innocent you are, it will still happen. So what do we do? Simple! Get to know your medical board! It's the board that decides whether to pass your case up to the courts, so act early and neutralise it before it gets there! Humans are a very subjective species. Medical boards are full of humans. Logic thus says, medical boards are subjective. Use it to your advantage. Find someone, who knows someone's friend, who knows someone's aunty, who knows someone's brother, who knows someone's cousin, who knows someone's best friend, who knows someone on the board. Then buy him wine, or her some flowers. Nothing influences passing judgement on someone more than "Hey I know that guy! He's alright!"

Informed Consent

It is not enough to simply ask the patient, "Is it OK for me to go ahead?" You must ensure that the patient has been disclosed all the relevant information and results regarding the tests that led you to the proposed management, as well as details regarding the actual proposed management. You must inform them of the potential benefits of this management, as well as the potential risks involved. Following this, you must then tell them of the probabilities that the aforementioned benefits and risks would occur. You must then ensure that they are aware of all other treatment options that are available to them. Whilst giving all this information, you must ensure that you haven't coerced them into making a decision, and that their final choice is not confounded and is free from bias. Somewhere along the line you must make sure that they are still with you, and haven't gone insane with information overload. If they are still there, you must then ensure that the patient is competent to make the decision themselves. This may involve various tests of mental and psychological stability. Should they not be competent enough to make an informed decision, their next-of-kin, or court-appointed "decision-maker" needs to be soughted. Once an informed decision is made, and consent is gained, you must then obtain written documentation as evidence that the consent process is completed. This often requires you to find a pen of some sort and the patient to read about seven pages of size 4 font writing. Good luck to you if the patient doesn't read English. Once all this has been completed, it is likely about 2:21am in the early morning, and the practice has been closed for the past five hours.

Basically, what I'm saying is, learn to become a 24 hour doctor in order to accommodate all the informed consent requirements.

Med student types (in a lecture theatre)

It's Friday morning, and I'm sitting at the back of the lecture theatre. I always feel bad whenever I don't listen in to lectures. But from this back row, I can see pretty much everyone else's laptop screens, and all but about six people are obviously not listening. I feel quite good now. Anyway, there's just no way I can tune in, so in order to keep awake I present to you:

Med Student Personalities in a Lecture Theatre

Facebook Stalker - Systematic reviews show that 120% of students with a laptop in any lecture will end up on Facebook at some point. Chances are, you are part of this group. You like to update your status about just how bored you are with the lecture. Not content with that, you will also talk to the person sitting next to you with Facebook chat, to express how bored you are. Congratulations! You may have just found the most efficient way of communicating with someone 30cm away from you: By relaying the message through some IT office halfway around the world.

The Gamer - You might be playing solitaire. Perhaps it's Farmville. Maybe it's a flash game on some website. Whatever the game, you pale in comparison to the people who are playing counter-strike against each other from opposite sides of the lecture theatre.

Rubber Neck - Sleep is for the weak! That's your motto. It got you into med and by Jebus, it's gonna get you through the course. Of course you have to sleep at some point in time, and what better time than during a lecture. Dim lights. Monotonic voice. The soothing sounds of laptop keyboards typing away. You don't need a pillow. Your neck was made flexible for a reason. Everyone else is laughing at you everytime your head flings forward or to the side, and then snaps back like a rubber band. But that's OK... just don't drool as well.

Arm Stretcher - You just can't stop stretching that right arm of yours. Every three slides you feel the urge to stick that right hand up, and ask a question to the lecturer. Don't worry about the fact that your question will be answered on the next slide anyway, or that all your questions will eventually need a combined total of 18 minutes to answer, just make sure you get to stretch that right arm. Cramps are never a fun thing to have.

The Rager - No I am not referring to raging lesbians, I am talking about the ones that get worked up into an angry fit of rage. You are forever linked to the preceding med type. When that arm goes up, somewhere, in some corner of the theatre (usually the back corner) the sound of a fist smashing against a laptop can be heard. That fist is likely yours. You hate people that waste your time, and believe that learning is best done with your mouth shut and your ears open. (Open eyes, and conscious state are optional)

Multi-Tasker - You are quite talented. Your eyes can concentrate on your laptop screen as you power through your next tute or PBL presentation, whilst your ears are expertly trained into the voice of a lecturer like a dog. Of course, you're brain is a bit retarded and can only take one thing at a time, so either your tute answers are gonna suck or that lecture just went straight out the other ear. That's alright though. The important thing is, you believe you got both things done at the same time. And that's efficiency.

Chronic Latecomer - Oops, you slept in again! You've done it five times this week already, and it's only Tuesday! Mathematically impossible, but you have a knack of finding a way to do this!! You only have one choice: skip breakfast. Um, WRONG! Bring your breakfast to the lecture. Nothing says professionalism and class than a bowl of weet-bix in the back row. Next time you might consider upping the ante by bringing in a sandwich press.

Ninja - The number of 'ninjas' tends to fluctuate, with a significantly higher proportion seen the closer it gets to Friday afternoon. You are undoubtedly the smartest of the entire student cohort. You are so smart, in fact, that you can attend the lecture from the comfort of your own car seat, whilst driving back to Melbourne.

Copycat - You type out *everything* on the slides that are presented even though it will be made available later on the web. Your excuse is usually "it helps to keep me awake". You, my friend, need to discover the joys of caffeine, which leads me to...

The Addict - To you, having four lectures in a row after lunch amounts to torture by forcible watching of Grey's Anatomy. There is no way you can last the next 59 minutes and 59 seconds of the first lecture, let alone the next three ones. Your only saviour? A coffee. Really struggling? Then only a Mother will do - $3 worth of guaranteed consciousness, at the expense of getting diabetes later on in life. You never sit in on an afternoon lecture without one by your side. No food or drinks allowed in the lecture theatre? That's OK, a can of Mother is in its own category of consumable goods.

The Territorial Marker - Sure you may not have urinated on that seat like a canine, but hell hath no fury on the poor unfortunate soul that decides to sit on your chair. Yes, you could've sat on any of the one hundred and fifty other seats in the lecture theatre, but that would go against everything you stand for. There is something about this particular seat. It might be the balanced mood lighting, or perhaps it's a Feng-Shui thing. Either way, you have an obsessive compulsive disorder.

Chair Squeaker - You just can't sit still for more than five minutes without shifting positions. Either that or you have haemorrhoids. Your frequent ass-shifting causes your chair to squeak like a tortured duck. You are quite funny when there's a group of you doing it at the same time.

Old Schooler - You are a technological dimwit that can't get your head around having to click on the "start" button to shut a computer down. You don't care that every student was given free laptops by the faculty. That's not how you roll. For you, when it comes to note-taking, only a pen and paper will do. In fact, if you had your way, we'd all be writing with a quill and black ink, which coincidentally would make for some awesome cross-lecture-theatre ink fights.

Model Student - You are sitting in the lecture, listening in intently, and taking due and diligent notes for the entire 60 minutes ........... hahaha! I lie. Such a thing doesn't exist.

The Meaning of Life...

... is like doing one of those frustrating cryptic crosswords. You know there's an answer. It's just that a) it requires too much thinking to work it out, b) you're never really sure if you've got the right answer, and c) when you find that answer and tell others about it, people think you need to go out and get laid a bit more. Unlike a crossword though, the meaning of life usually doesn't have one single correct answer. So trying to explain it would be as productive as finding the corner of a circle. It would also inevitably end up in one of those philosophical arguments where fancy words such as "absurdism", "utilitarianism" and "post-modernism" get thrown around by people, whilst I just smile and nod and do my best to feign that I have an IQ with three figures in it.

I'm sure there's several variations to whatever it means. I've heard people say that the meaning of life is to do whatever is good for others. Fair enough, but then what if that other person is the second coming of Hitler, Saddam Hussein, Napoleon, and the Cookie Monster combined? Another version of it is simply to live, and keep populating the world. A very pragmatic approach, yes, but then anyone who adopts this version comes across as a horny rabbit on heat that just wants to bonk anything that moves. My favourite is probably the "to love and be loved" purpose to life. Everyone wants to be loved. I like to be loved. Love me. Cuddle me. Hold me. Hold me. Never let me go until you've told me. Told me. What I want to know and then just hold me. Hold me. Make me tell you that I'm in love with you...... No wait, those are just lyrics to a song.

Anyway, the point of all this is to say that for the first time in my life, I feel like I may have found my meaning and purpose, whatever that may be. Hooray!

Just don't ask me to explain what it is, 'coz I wouldn't have the slightest idea where to start.