769 ETHICAL IMPLICATIONS OF STUDENT-PATIENT INTERACTION ON PEDIATRIC SERVICES: A STUDY OF PEDIATIC CHAIRPERSONS

Abstract

Should parents be informed that medical students may perform invasive procedures on their children? Surveys were sent to all university pediatric dept. chairpersons (n=124) to ascertain policy governing ethical aspects of student involvement in the care of children. Surveys were returned from 99 chairpersons (80%). Seventy percent of pediatric departments specifically inform parents that students will be involved in the general care of their children but only 8% of depts. specifically obtain permission for student participation in all aspects of care. Depts. were less likely to obtain specific permission for involvement in noninvasive aspects of care (18%) than in invasive aspects (46%). The common explanation was the presumption that students are part of the hospital team; therefore specific permission for their participation was not necessary (60%). Fourteen percent of chairpersons felt that seeking permission for student involvement in some aspects of care might, through parental rejection, be detrimental to the students' education. With respect to invasive procedures 65% of depts. invoked the team concept - “we will do it together” while 4% actually informed parents that students would perform the procedures. There is considerable variability in the approach to the ethical issues surrounding student involvement with pediatric patients, and thus variability in conforming with federal and JCAH guidelines.