Consent for Student Involvement in Patient Care: Developments and Tensions in New Zealand Law and Medical Education
Simon Walker1, Lynley Anderson1,2, Josephine Johnston1,3, Bioethics Centre, University of Otago Dunedin2, Dunedin Otago3, New York USA 1Bioethics Centre, University of Otago, Dunedin, Otago, New Zealand2Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand3The Hastings Center, Garrison, New York, USA
Abstract
Student involvement in patient care is an essential part of learning to be a doctor. It is now widely recognised in New Zealand that this involvement should only happen with the patient’s consent. However, obtaining this consent can be challenging given the range of ways and contexts in which students are present for or involved in patient care. Concern about these issues was heightened by a recent New Zealand Health and Disability Commissioner (HDC) case relating to unconsented student involvement in a procedure to insert an IUD in a vulnerable patient. Between 2020 and 2023, senior faculty from Aotearoa New Zealand’s two medical schools collaborated on an updated consensus statement that aimed to address these challenges. This updated statement describes how consent can and should be obtained across different clinical contexts to uphold the values underpinning informed consent while still providing learning opportunities for students.
This panel will review the educational, health policy, ethical, and legal tensions that can arise in obtaining consent to student involvement in patient care. We will discuss the process of developing the updated New Zealand consensus statement, noting key points of debate. We will also share a new standardised consent form that was developed following the HDC case and consensus statement and that has thus far been implemented in one NZ region. Finally, with the audience’s involvement, we will consider counter arguments to the current position and interrogate alternative approaches to navigating ethical, legal, and health policy tensions between medical education and patient autonomy.
Biography
Simon Walker is a senior lecturer at the University of Otago’s Bioethics Centre. He convenes the ethics teaching for several of the University’s healthcare professional programs and is the convenor of the Otago Medical School’s Professional Practice Domain Sub-Committee.
Lynley Anderson teaches ethics and professional issues to health professional students. Previously HOD of the Bioethics Centre, Dunedin School of Medicine, she is currently Deputy Dean. Lynley was a founding co-editor of Journal of Bioethical Inquiry and currently researches unacceptable behaviours experienced by clinical students from patients and staff.
Josephine Johnston teaches medical law and bioethics at the University of Otago and is a Senior Research Scholar at The Hastings Center. Her research addresses ethical, legal, and policy issues in medicine and science, with a focus on emerging biotechnologies in human reproduction and genetics.