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During their first days at Stanford, medical students ponder the ethical challenges ahead

students reading oath2 - 560

In an effort to help prepare this year’s crop of new medical students for the future challenges of keeping true to the spirit of the Hippocratic Oath – to first do no harm ‑ Stanford's School of Medicine held a new discussion session during orientation.

In between learning about housing and schedules and all the necessary details of starting medical school, the 90 new students who started class on Monday joined with two deans of the school last week to discuss one of the most controversial topics in the world of medicine: euthanasia.

Included among the students' summer reading assignment was the book Five Days at Memorial, a blow-by-blow account of the days medical staff and patients spent trapped in a New Orleans hospital after Hurricane Katrina struck. Left without electricity or sanitation, staff slept little and worked endlessly to care for the sick and dying patients not knowing if any of the patients – or anyone else trapped at the hospital — would survive. An online story explains why the book was assigned as summer reading:

Most [new students] had not yet faced the responsibilities they will encounter routinely as physicians. It was the ethical and emotional challenges ahead that [Lloyd Minor, MD, dean of the medical school, and Charles Prober, MD, senior associate dean of medical education] hoped to explore during the book discussion. “I think one of the key lessons from this book: If we’re going to make progress in medicine, we’re going to have to face realistically when we make errors," Minor said. "Progress only occurs when we are able to frankly address those situations and acknowledge those errors.”

The book describes health-care workers treating patients in a way that could arguably violate tenets of the Stanford Affirmation. “You will be reciting this later today after you receive your white coats and stethoscopes,” Prober said. “Hopefully, the affirmation will have more meaning to you. It will help you to reflect more deeply on the words as you ponder it into the future.”

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The book describes how medical staff and patients had to fend for themselves in the days following Hurricane Katrina. After the waters receded, and authorities entered the hospital, 41 bodies were found. Three health-care professionals, including one physician, were arrested for murder. A New Orleans grand jury ultimately refused to indict them on charges of involuntary euthanasia and murder, but exactly what happened during those five days, when temperatures soared, sleep was rare and proper sanitation was nonexistent, remains unclear.

Exactly how and why at least 17 of these bodies were found to have been administered lethal doses of drugs led to an in-depth discussion by the medical students on what is compassionate care and what is involuntary euthanasia and when, if ever, is the latter okay. More from the article:

What is clear, as Prober described it, is that the lack of planning, communication and panic worsened an already unimaginable situation, one that no physician ever wants to face.

"As I read the book, I imagined how horrible it would have been to live through this tragedy," Prober said. "It’s amazing they stayed after abandonment by the federal government... it became very clear what we could talk about,” Prober said. “Did the care providers do the right thing? ... The question is whether or not it was kindness or at the other extreme, murder.”

Previously: Stanford Medicine’s white coat and stethoscope ceremony, in picturesMedical students start "transformational" journeyWhat happened inside New Orleans' Memorial Hospital? A conversation with Pulitzer Prize-winning author Sheri Fink and Murky waters: A look at Memorial Medical Center after Hurricane Katrina
Photo, of new students reading "The Stanford Affirmation", by Norbert von der Groeben

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