Medicine Interview Hot Topics: Euthanasia
Euthanasia is “the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma.” Please note, euthanasia is different to assisted suicide: assisted suicide is where a physician makes the lethal injection/drug available to the patient without actually administering it, while euthanasia is where the physician takes the active role to administer the lethal dose.
There are two types of euthanasia: voluntary (where the patient makes the conscious decision for euthanasia) or non-voluntary (where the patient is incapable of making a decision eg. when in a coma, so the decision is made for them). Within these, there are two further subtypes for each: active and passive euthanasia. Active euthanasia involves physically giving a lethal dose to a patient, while passive euthanasia involves removing life sustaining support to allow a patient to die.
What does the Law say?
Under UK law, both euthanasia and assisted suicide are illegal. However, passive euthanasia is considered part of palliative care and is therefore not technically considered as euthanasia in the eyes of the law. This is because, in certain scenarios where there is no hope of survival, the patient may be merely using resources which may be used successfully on other patients, or it may be causing them more pain to be alive than to die. There are various situations which can be explored and are therefore very testable in interviews.
Potential Questions which may be asked in the Interview
There are multiple questions surrounding euthanasia which could come up in the interview. However, they are all very similar, and revolve around a question of medical ethics. The scenarios for each interview question may change, but below are listed a few questions which may come up:
- What are your opinions on euthanasia?
- Should euthanasia be made legal in the UK?
- Is it right that patients travel to places such as Dignitas in Switzerland to be euthanised?
- A patient refuses lifesaving treatment. What would your course of action be?
- To what extent do you think euthanasia should be legalised?
How to answer Questions on Euthanasia
These questions can be asked in both mmi and panel interviews and are a classic example of how interviewers test a student’s ability to apply ethical concepts.
The best way to answer these questions is to consider the four principles of medical ethics: justice, beneficence, non-maleficence and autonomy. Attempt to apply these one by one in your head and decide which ones are applicable to the question. For euthanasia related questions, all of the principles can be addressed, and spoken about. Implement them and ensure that you lay out all of your arguments for both sides of the argument using the four principles to structure your answer. You can use these as the four main points for your answer, and then base your arguments around them. Interviewers will be impressed by not only your well-supported arguments by considering all aspects of the issue, but also by how methodical your thought process is. This method can generally be applied to all ethical questions.
How can you Include the Topic of Euthanasia in your Interviews?
Although this topic is often brought up by the interviewer to test your grasp of medical ethics, you can also tie it in with other questions that may arise. This is done by directing the conversation to the topics that you are most confident with and is a good method to increase your chances of success in medical school interviews. This is a definite skill which can be learnt through practice and cannot be used in every interview (this depends on the interviewers) but is extremely effective when used effectively. One example of where euthanasia could be mentioned is in questions relating to limited health resources (eg. by legalising euthanasia, this would potentially reduce the demand for limited health resources).
In summary euthanasia represents a controversial but important topic that is commonly addressed in medical school interviews. Ensure that you have a good understanding of the differences between the different types of euthanasia, as well as the difference between euthanasia and assisted suicide.
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