Two patients are in desperate need of a lung transplant, but there is only one available. Talk about how you would decide between a 70 year old retired teacher and former smoker and a 31 year old father of two young kids.
As a prospective medical student and future physician in practice, there is no doubt that you will face many difficult decisions in patient care in the future. Medical schools love to present ethical scenarios like this during the MMI to gauge a candidate's ability to think clearly in a tough situation, consider many different factors in their decision-making processes, and communicate with others as part of the decision-making process.
While medical school multiple mini interviews can be stressful, ethical scenarios that are open for interpretation can be the most taxing on candidates. Remember that these types of questions aren't asked to gauge your ethics in morals in medicine because you are a prospective medical student and will learn a lot about this in the years to come. Instead, the school you are interviewing with wants to hear that you can process your thoughts and actions in the most difficult situations.
The reality in an ethical scenario like this is that you likely don't have enough information to make an ethical and just decision. It is perfectly acceptable to let the evaluator at this station know that you will collect as much information as possible to make the best decision possible. Clearly define the issue, and then walk through how you would collect further information to make your decision. It is safe in the end to make assumptions about each patient as long as those assumptions lead you to a clear path on who should receive the first transplant.
"This is a difficult situation that likely arises from time to time for transplant pulmonologists. As the situation presents itself, two patients need a transplant, and both have varying bios that I need to use to determine who should receive the first lung available for transplant. My first step would be to collect as much information as possible on each patient and the lung available for transplant. Factors like blood type match would be very important and could potentially rule out one of the transplant candidates immediately. The other factor to look into would be if either transplant candidate has any current or past medical issues that could complicate the transplant. If both remained viable candidates, I would work with my team to gauge how soon another lung may become available and decide based on which candidate had the more urgent medical need here. But in the end, if all factors were equal and I had to make the decision myself about who received the transplant, I would opt for the younger father. It would be difficult, but in the end, he likely has more life to experience in front of him and the need to support and be there for his two young children."
