Medical students organize health care panel

Six experts discuss controversial issues Twenty-four second-year medical students organized a discussion panel on the cost constraints of health care Wednesday night in the Dunlop Auditorium. Six expert panelists discussed three health care dilemma scenarios. After each case, audience members were able to ask questions. The series of cases provoked the issue of providing high-quality health care in the face of such variations as health maintenance organizations and insurance company and immigration regulations. The first scenario invoked a debate on informed consent. Legal Studies and Health Care Systems Professor Arnold Rosoff said he thinks practitioners have a legal obligation to illuminate every alternative to the patient before embarking on therapy. Gail Slap, who directs the Adolescent Medicine program at the Children's Hospital of Philadelphia, said she agreed with Rosoff, but added that it is not always necessary to go through every exhaustive implication of a headache if it is not relevant to the specific case. "A primary care provider's role is to help the patient balance the risk," she said. And William Kelley, dean of the Medical School and chief executive officer of the University Health System, said that sometimes even if the physician is aware of possible treatments, he may not be knowledgeable enough to make decisions regarding therapy. In these instances, the doctor should refer the patient to an expert, Kelley added. Mark Pauly, vice dean of Wharton Doctoral Programs, said a clarification of regulations could prevent much controversy. "These dilemmas could be avoided if they thought ahead -- we need clear guidelines," he said. The second case addressed the uses and payment methods for experimental medical treatment. The students offered the following scenario: A woman with breast cancer opts to participate in an experiment involving bone marrow therapy, and does not receive treatment because she was randomly assigned to a control group. The woman dies. Her husband then tries to sue the insurance company. Undergraduate Nursing Dean Mary Naylor said fine tuning the distinction between experiments and standard treatments may prevent potential problems such as these. Most insurance companies do not cover experimental therapies. The third case centered around the legalities of offering health care to undocumented immigrants. The student organizers asked, should clinicians turn away a little boy with a serious ear infection on the basis of his illegal alien status? Center for Bioethics Director Arthur Caplan said that in cases like these, refusing to obey unjust laws may be the solution. "This law is not acceptable," he said of the nation's immigration policy. Second-year Medical student Julian Husbands, who helped organize the panel, was enthusiastic about the benefits of the program. "It's time for the students to take a proactive role in the changes in medicine," he said. "And in a forum like this, we are able to get ideas from the best minds and create an interactive discussion so that the future of medicine can thrive." Second-year Medical student Jean Tsai said she was pleased with the myriad of opinions and expertise present in the discussion. "I thought it was a really good idea to have those questions asked and presented in different perspectives because there's really no one answer to these complex problems," she said. The panel was held in memory of Thomas Langfitt, a University medical student who died 15 years ago. It was co-sponsored by the office of the Vice Dean for Medical Education and the Leonard Davis Institute of Health Economics.

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