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Journal of General Internal Medicine

, Volume 17, Issue 10, pp 774–778 | Cite as

Ethics of practicing medical procedures on newly dead and nearly dead patients

  • Jeffrey T. BergerEmail author
  • Fred Rosner
  • Eric J. Cassell
Original Articles

Abstract

OBJECTIVE: To examine the ethical issues raised by physicians performing, for skill development, medically nonindicated invasive medical procedures on newly dead and dying patients.

DESIGN: Literature review; issue analysis employing current normative ethical obligations, and evaluation against moral rules and utilitarian assessments manifest in other common perimortem practices.

RESULTS: Practicing medical procedures for training purposes is not uncommon among physicians in training. However, empiric information is limited or absent evaluating the effects of this practice on physician competence and ethics, assessing public attitudes toward practicing medical procedures and requirements for consent, and discerning the effects of a consent requirement on physicians’ clinical competence. Despite these informational gaps, there is an obligation to secure consent for training activities on newly and nearly dead patients based on contemporary norms for informed consent and family respect. Paradigms of consent-dependent societal benefits elsewhere in health care support our determination that the benefits from physicians practicing procedures does not justify setting aside the informed consent requirement.

CONCLUSION: Current ethical norms do not support the practice of using newly and nearly dead patients for training in invasive medical procedures absent prior consent by the patient or contemporaneous surrogate consent. Performing an appropriately consented training procedure is ethically acceptable when done under competent supervision and with appropriate professional decorum. The ethics of training on the newly and nearly dead remains an insufficiently examined area of medical training.

Key words

medical education invasive procedures medical ethics 

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Copyright information

© Society of General Internal Medicine 2002

Authors and Affiliations

  • Jeffrey T. Berger
    • 1
    • 2
    Email author
  • Fred Rosner
    • 3
    • 4
  • Eric J. Cassell
    • 5
    • 6
  1. 1.Received from Winthrop-University HospitalMineola
  2. 2.Stony Brook School of MedicineStony Brook
  3. 3.Mount Sinai ServicesQueens Hospital CenterJamaica
  4. 4.Mount Sinai School of MedicineNew York
  5. 5.Weill Medical College of Cornell UniversityNew York
  6. 6.New York-Presbyterian HospitalNew York

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