New Zealand medical students and their involvement with patients in the context of sensitive examinations: what does consent have to do with it?
Dr Phillipa Malpas, Department of Psychological Medicine, University of Auckland
Wednesday, 10 July 2019, 11am to 12.30pm
Ethox and the Wellcome Centre for Ethics and Humanities are based at the Big Data Institute, University of Oxford, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Oxford OX3 7FZ. The talk will be held in seminar room 0.
Between 1966–1987, a clinical trial led by O&G specialist Dr Herbert Green was undertaken at National Women’s Hospital in Auckland. Green theorised that carcinoma in situ identified in cervical smears was unrelated to cervical cancer. Many women had no knowledge they were part of the study, many did not consent to their involvement and as a result of the study, some woman developed cervical cancer and a number of women died. A ministerial inquiry investigated the study and consequently found other unethical practices at National Women’s.
As a result of the Cartwright Inquiry, a number of recommendations were made (and implemented) that changed medical practice and medical education in NZ forever.
Over the past decade, the literature has published a number of studies highlighting the use of patients (both male and female) as learning tools for medical students – often without the patient’s knowledge or consent. University of Auckland senior medical students consistently report being asked to observe or perform sensitive examinations on both conscious and unconscious patients, without their consent, in the clinical environment.
In my talk I’ll provide further context to the issue of consent in this particular context. I’ll reflect on changes made to medical education as a result of the Cartwright Inquiry, what’s currently happening, and where I believe we need to focus our attention going forward.
I trained in philosophy with a particular interest in medical ethics. My PhD focused on the ethical dimension of children in relation to predictive genetic testing for adult onset diseases. During my PhD I became interested in the ethical issues arising within the area of assisted dying specifically that of physician assisted death, and I worked in this area for a decade.
For the past two years my research has focused on ethical and professional violations within medical education, as experienced by senior medical students. I have a particular interest in the issue of consent in the context of patient and medical student interactions concerning sensitive examinations.