CASE

“Omit the mistake”

When I was a third year medical student, I observed that a patient was suffering an adverse drug reaction because he had been given an overdose of the medication. The patient was informed that his discomfort was due to an allergic reaction to the medication. He was not told that an order had been written improperly. I was then instructed to write a note documenting the incident, but omitting the “mistake.”

CASE

“Was I acting under false pretenses?”

I was a resident in internal medicine when a patient, to whom I was not assigned, was admitted to our service with pulmonary emboli in both lungs. I happened to meet a fellow intern outside the patient's room who said “If you want to hear some really clear rubs, check this guy out.” When I entered the room, the patient obviously assumed I was another of his physicians coming to do an exam. He lifted his gown so I could listen with my stethoscope. I was aware that the patient was under the impression he was receiving medical care, while in reality he was serving as an educational experience for me. I said nothing to enlighten him, but I wondered, was I acting under false pretenses?