Instead of the Topical issue of the week I am recommending this Ted Talk professor Aubrey de Grey is a crazy looking chap with a crazy sounding idea- that we can end ageing and achieve immortality. However his ideas do have merit and have been taken seriously. They were recently discussed in the BMJ (British Medical Journal) This would be an interesting topic in an interview if asked about what the future of medicine holds / what excites you most about the future of medicine e.t.c.
The Tony Nicklinson case is a good example of an ethical scenario. You will be given an ethical scenario in most medical school interviews. You may be asked the following question:
‘Tony Nicklinson, a severely disabled man with ‘locked in syndrome’ and wishes to die. He is requesting the help of doctors so he can avoid suffering as the only way he could kill himself would be to refuse food and drink and that he says would be a slow and unpleasant way to die. Although he had severe brain damage he fully understands his situation and is eloquent and articulate. How should a doctor respond to his request?’
Answer next week!
This is a subject that is often in the news. Over the last two weeks the Tony Nicklinson case has been extensively reported and Channel 4 had a programme ‘Let our Dad die’. Lord Falconer, the campaign group Dignity in Dying and the all-parliamentary group Choice at the End of Life are behind plans to table a members’ bill and issued proposals for discussion last week.
Tony Nicklinson is a man with ‘locked in syndrome ‘who wishes to die and took his case to the high court. He is asking for ‘physician assisted suicide’ as due to his condition the only way he can commit suicide is to refuse food and water and this he argues would lead to a slow, painful death.
‘What is ‘locked in syndrome’? Mr Nicklinson is unable to make any movements except for blinking after a massive stroke. His mind is active and he communicates by looking at a letter board and blinking and his wife interprets the blinks for letters. It takes him a long time to communicate a single word, he suffers from painful spasms and he says he has no dignity as he needs help to empty his bladder and bowels. He is not arguing for euthanasia to be available to all – he is asking that judges assess cases each on their own merit.
Arguments against assisted suicide;
- ‘Thou shalt not kill’ is one of the oldest moral commands.
- Those that are infirm may be pressurised to die or made to feel selfish or a burden if there was this option.
- Slippery slope arguments. The ‘slippery slope’ argument holds that if assisted suicide was practised for people like Mr Nicklinson then it would become acceptable to allow it for less clear cut cases and eventually you may end up with a situation as in Nazi Germany where those deemed to be defective were killed.
- With good pain control and counselling, suffering will be minimised.
Arguments for assisted suicide:
- The person’s right to autonomy, control over his or her life, should mean that if this is their wish it should be respected.
- Some, such as Debbie Purdy who has multiple sclerosis, have argued that if her husband faced prosecution for helping her to commit suicide she would travel to Dignitas earlier while she could do so alone. However if the law permitted her to have help she would delay dying.
- Even with the best palliative care [treatment of the dying] suffering and pain are common. Dr Ann McPherson, who set up the charity and website ‘Teenage Health Freak’, supported a change in the law on assisted dying, died recently from pancreatic cancer. Her daughter wrote in the BMJ ‘our mum died slowly and in pain. …The law needs to change to allow terminally ill but mentally competent people the right to a more dignified death than my mum’.
- There was a vote last week by campaigners to change the BMA s stance on assisted dying from against to neutral. It failed.
For a more detailed discussion of this subject read p83-88 in my book Medical School Interviews. All You Need to Know. The Knowledge
Look up the [and visit the open days of] the medical schools you want to apply to and list ‘key words and phrases’ that come up in their prospectus such as ‘appreciation of the human story’ ‘proven commitment’ and the ‘knowledge of the reality of becoming a doctor’ and bear these in mind when you write your personal statement.
- Introduction –Why you want to be a doctor. The hardest bit. Try to write something original but it is so hard to say something that is not a cliché as admissions staff see thousands of applications. Do not hyperbolise the virtues of doctors. Statements such as ‘Medicine is the only career that combines a love of science and caring for people’ are just not true and denigrate other professionals. Graduates should describe a “eureka” moment that made they decide that they wanted to medicine.
- Work experience – don’t list places or procedures. Remember they are most interested in what you learnt ‘from you experience not what you did. Did you notice that doctors required any special qualities such as ‘courage’, ‘good communication skills’? Do you have these and are there any examples that prove that you have these? Perhaps mention the downsides of being a doctor and why that does not put you off. Remember doctors are dealing with human beings- it is no longer considered correct to refer to patients by their disease such as ‘the diabetic’ in bed 4 or the ‘asthmatic’ in bed 6 – it dehumanises them. Remember the ‘patient story’ is important. Referring to this shows empathy.
- Voluntary work; Again be brief about what you did and write mainly about what you learnt. It is probably good to mention a few of those ‘key qualities’ such as good communication skills, any leadership skills teamwork etc in this section as well as the next.
- Extra curricular activities. Universities are looking for people who excel in non academic fields in addition to getting good grades. What ever your passion or hobby always relate it back to how the skills you have learnt will help you in a medical career.
As in the previous paragraph mentioning how you demonstrated ‘competence skills’ such as teamwork, leadership skills, coping with stress or challenging behaviour, compassion and empathy.
They also want to know that you are sociable ‘well rounded’ person who knows how relax and ‘de-stress’. It is always an advantage if they think you may be able to contribute to University life eg the rowing team or drama society.
5. You may want to write about something you studied and enjoyed. It is not necessary to list every subject. Again focus on one or two points and avoiding listing. Perhaps mention books [or journals] you have read and why you found them interesting.
6. ‘Love of science’ it may be important particularly for Oxbridge entry to refer to this. Say what it is about science that interests you – ‘scientific logic’ for example.
7. The Conclusion . Sum up and try to end with a flourish.
NEVER DISPLAY A HINT OF ARROGANCE BUT NEVER PUT YOURSELF DOWN
LEAVE RELIGION AND ANY STRONG ‘MORAL’ STATEMENTS OUT – you may come across as opinionated or superior.