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Saturday Practice MMI

sharmadharma

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  • 8 years later...
juc25 Newbie

juc25

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Posted

Hi Everyone,

 

I know there were few of us who were interested in doing MMI practice run this saturday. I have booked the room in Irving K Barber today and anyone who is interested in coming, please confirm by replying to this thread or PM me.

 

Irving K baber 415 and 416

2:00 - 4:00 pm

Saturday, January 10

 

I booked two rooms just in case we have more than 8 people.

 

Thanks

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juc25 Newbie

juc25

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Posted

Hi Everyone,

 

I think there are about 15 of us coming tomorrow. I suggest we meet in Room 415 and we can do quick intro. I hope everyone is bringing questions so we can do a run-through of MMI.

 

I was thinking we can break into two groups and discuss potential answers. Then one group will act as interviewer and the other as interviewee and vice versa. This way, we are all exposed to questions/topics to an extent. What do you think? I am open to suggestions and flexible as to how we should use our time.

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babydoctor Newbie

babydoctor

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Hi all,

 

My weekend just got totally rearranged and I won't be able to make it out to UBC for 2:00 today, although I'll try and get to the next meeting! But, in the mean time, here's the question I was going to bring in case people want extra material to look at:

 

Bill, a 22-year-old man engaged to be married in four months, has just been diagnosed as brain-dead after a car accident. His father arrives and agrees to multiple organ donations, and also requests that his son's sperm be obtained and frozen for later use. Bill's fiance is unavailable for consultation, but the father believes that she may be interested in conceiving Bill's child so that "a part of him can live on." Bill was his father's only son, and the father states that even if the fiance is not interested in using the sperm, he would welcome the donation so that the family line could be continued in at least that fashion. Assuming that adequate technical means are available, should the sperm be retrieved?

 

The question is from a book of ethical dilemmas and comes with a commentary, so if anyone is interested in what the "experts" thought after the fact, let me know.

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justin85 Newbie

justin85

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I don't think it should be a question like "why u want to be a physician?" but rather ethical dilemma questions because I believe question like that can be well rehearsed when we are on our own.

 

I heard that "why do you want to be a physician" is one of the least asked questions!

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youngdad Newbie

youngdad

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Hi all,

 

My weekend just got totally rearranged and I won't be able to make it out to UBC for 2:00 today, although I'll try and get to the next meeting! But, in the mean time, here's the question I was going to bring in case people want extra material to look at:

 

Bill, a 22-year-old man engaged to be married in four months, has just been diagnosed as brain-dead after a car accident. His father arrives and agrees to multiple organ donations, and also requests that his son's sperm be obtained and frozen for later use. Bill's fiance is unavailable for consultation, but the father believes that she may be interested in conceiving Bill's child so that "a part of him can live on." Bill was his father's only son, and the father states that even if the fiance is not interested in using the sperm, he would welcome the donation so that the family line could be continued in at least that fashion. Assuming that adequate technical means are available, should the sperm be retrieved?

 

The question is from a book of ethical dilemmas and comes with a commentary, so if anyone is interested in what the "experts" thought after the fact, let me know.

 

This is a good one. It seems important to continue to try to establish contact with the fiance. In the mean time, Bill's father is present, and is a blood relative. He would likely be the next of kin. The father is in a pretty good position to make decisions on Bill's behalf, especially if it is an emergency.

The question here is really whether the sperm should be taken. It seems rational to me. I think it should be taken and preserved. When the fiance is contacted, the plans for the sperm should be made clear to her, but only after a sensitive consultation discussing treatment and outcome options for Bill.

On that note, I don't know about organ donation for someone who is brain-dead. It doesn't really seem prudent, but then again their may be a chance of survival. If there is a chance, and the father is a good candidate then I think that should be done right away.

The father is looking out for the fiances interests here. There may be debate later on if Bill does not make it and the father and the fiance disagree on what to do with Bill's gametes. I don't know who has the rights to decide what happens to the sperm, but I would have to lean toward the father since he is a blood relative. Things may be different if Bill was already married. Then again the length and nature of their relationship should be considered. Hopefully it would be easy to determine what Bill would want through discussions with both. A battle over the sperm would be an unfortunate situation that may have to be settled by the courts.

The best solution would probably be one that got the father and the fiance on the same page as early as possible.

 

What did the experts say?

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avenir001 Newbie

avenir001

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Bill' date=' a 22-year-old man engaged to be married in four months, has just been diagnosed as brain-dead after a car accident. His father arrives and agrees to multiple organ donations, and also requests that his son's sperm be obtained and frozen for later use. Bill's fiance is unavailable for consultation, but the father believes that she may be interested in conceiving Bill's child so that "a part of him can live on." Bill was his father's only son, and the father states that even if the fiance is not interested in using the sperm, he would welcome the donation so that the family line could be continued in at least that fashion. Assuming that adequate technical means are available, should the sperm be retrieved?

 

[/quote']

 

just bcuz youngdad wanted to know what i think... :)

 

ok so here we ask is it ethical to donate organs or retrieve sperm from a brain-dead patient who has not explicitly given consent when alive? To respect patient autonomy, we make decisions based on inferred consent here. As far as organ donation goes, we can ask family members if the patient had a wish concerning organ donation. If it can reasonably be inferred that Bill would approve or at least if there's no reason to blv that he would've refused, then I think it would be ethical to go ahead with it. And in this case, if there was disagreement between the father & the fiance, I'd be inclined to go with the father's wishes just bcuz he's the one who raised Bill and known him for longer and they probably have similar values, attitudes, etc about things.

 

Now as far as sperm retrieval is concerned, again we need to ask whether the patient's wishes can reasonably be inferred from his previous statements, goals, dreams, etc. Even if the father wants a part of Bill to live on and his fiance really wants his child, the most important question to ask is, can we infer that Bill would consent if he were able to do so? If the family (father & fiance) are in agreement that Bill would approve based on conversations with him when he was alive, then we can probably infer consent and I think it's justified. But if no such conversations took place, there's disagreement about whether or not he would approve, or the family is just guessing, we can probably conclude that there is not enuf evidence to infer consent. Also, perhaps Bill would approve of his fiance using his sperm but if there's no evidence that he'd approve of anyone else using it, then I don't think his sperm should be stored (to one day be made available to some woman who can have his child just bcuz Bill's father wants his son to live on). So if the fiance is not interested in using the sperm, I don't think it should be retrieved. And we also have to think about the kid too...the grandfather is too old to raise the kid himself, the kid's father is dead, and we can't just assume that Bill would want his child raised by a woman he's never known or if that's even a good thing for the child. So I'd say unless Bill had expressed his wishes to his family and the family is in agreement and the fiance wants the sperm, I would decline.

 

ok so there..now keep in mind that i failed last yr so maybe ppl should go with the opposite of what i think :P

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jma Newbie

jma

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You have very good points and I agree with your answer, although I am not 100% certain, but I believe that the spouse/partner has more authority in the decision making than the parent. However, i do not know if a fiance is classified as a spouse/partner. I think the decision goes to the spouse/partner > children > parents > siblings > relatives. Maybe someone here can confirm that?

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avenir001 Newbie

avenir001

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You have very good points and I agree with your answer, although I am not 100% certain, but I believe that the spouse/partner has more authority in the decision making than the parent. However, i do not know if a fiance is classified as a spouse/partner. I think the decision goes to the spouse/partner > children > parents > siblings > relatives. Maybe someone here can confirm that?

 

yes i think the order is right...spouse normally does have more authority than the parent, but i'm not sure where fiance fits either...i'd be more inclined to go with the parent's wishes in this case (eg about organ donation)..but i don't see how the sperm would be of any use to the father personally :D, so that's why i thought fiance has more authority there.

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