Elective ethics: doing more harm than good?
- By: Neil Graham
Did you hear the one about the medical student who did a caesarean section on elective? It goes a little like this: a woman arrives at hospital miles from anywhere with an obstructed labour. The medics are away on “urgent business” elsewhere, and the student seizes the scalpel, saving mother and baby. Backslapping occurs all round.
Less well known is the tale of the student who, rather too comfortable in a borrowed white coat, intervenes, kills both, and contracts HIV from a needlestick injury. Probably he’ll be less inclined to boast about this when he gets home. It would seem that gossip, not unlike research, is subject to a publication bias of sorts.
It’s the classic pre-elective conundrum, but there are broader ethical issues to consider before deciding to take an elective in a resource poor setting than whether non-experts should perform new procedures in emergencies. Many of these questions