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

Journal of General Internal Medicine volume 17, pages 774–778 (2002)Cite this article

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.

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Authors and Affiliations

  1. Received from Winthrop-University Hospital, Mineola, NY

    Jeffrey T. Berger MD

  2. Stony Brook School of Medicine, Stony Brook, NY

    Jeffrey T. Berger MD

  3. Mount Sinai Services, Queens Hospital Center, Jamaica, NY

    Fred Rosner MD

  4. Mount Sinai School of Medicine, New York, NY

    Fred Rosner MD

  5. Weill Medical College of Cornell University, New York, NY

    Eric J. Cassell MD

  6. New York-Presbyterian Hospital, New York, NY

    Eric J. Cassell MD

Authors
  1. Jeffrey T. Berger MD
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  2. Fred Rosner MD
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  3. Eric J. Cassell MD
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Correspondence to Jeffrey T. Berger MD.

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Berger, J.T., Rosner, F. & Cassell, E.J. Ethics of practicing medical procedures on newly dead and nearly dead patients. J GEN INTERN MED 17, 774–778 (2002). https://doi.org/10.1046/j.1525-1497.2002.11139.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2002.11139.x

Key words

  • medical education
  • invasive procedures
  • medical ethics