Physicians face an array of ethical conundrums, particularly in end of life situations.
PATIENT: Maybe you can just give enough medicine so I can sleep.
DOCTOR: I'll write for a sleeping pill for tonight.
PATIENT: Just something that will let me sleep, for good…
This video is based on a real medical case involving a leukemia patient. Isabel Jameson has been responding to chemotherapy, but now is in the emergency room with a bowel obstruction and is hesitant about getting the surgery that might save her life.
PATIENT: "I'm sick I'm tired, I'm just asking for something that will…
DOCTOR: Ms. Jameson? I can't help you commit suicide. And it's comments like that make me wonder whether it's your depression speaking instead of you…"
Her doctor must decide whether Jameson's mental state leaves her fit to make her own health decisions. The case is being used to teach med students here at the UC Davis doctoring program how to communicate, how to be ethical, and how to make good clinical decisions.
WILKES: One of the things about doctoring is that there are occasions where there are clearly right answers, but there are often situations where there is no right answer.
Dr. Michael Wilkes started the "doctoring program" 20 years ago at UCLA. Now he leads it at UC Davis.
He says future doctors need to be taught how to bring humanity to patient care. He says working in medicine, even as a student, can be stressful and de-humanizing. It requires long hours, little sleep, and a lot of exams.
WILKES: We're trying to preserve their humanity and reinforce the fact that patients aren't the enemy, patients are what we're here for, and we've entered this caring profession because we really want to take care of them, and to do that we need to be partners not have them be the adversaries.
He says the goal is to make future doctors more cost-conscious, prevention-focused, and patient-centered.
Dr. Wilkes shows the videos in the classroom, where they're only part of the program. First he meets with med school professors to coach them through the curriculum. Then the professors break out to teach students in small groups. There are many ethical discussions.
STUDENT: What is a depression that is so severe that you lack capacity and what is, you're depressed but you still have capacity. You know, I don't know how you tease that out.
Wilkes says it's hard to measure how better communication might lead to better health, but he says you'll probably see more satisfied patients.