NCPA - National Center for Policy Analysis

Dead or Dying Patients Being Used for Medical Training

November 12, 2002

The medical community doesn't like to talk about it, but some hospitals permit young doctors to practice on patients who are dead or nearly dead -- in other words, patients who are technically still alive, but beyond the help of even extraordinary measures.

Such practices raise a host of ethical questions that have, so far, been brushed aside.

  • The American Medical Association has adopted a nonbinding policy that no training be performed on newly dead patients unless the patient or family members had given consent -- but it failed to address medical training on nearly dead patients.
  • These practices have been standard at many teaching hospitals since the 1970s -- although policies differ widely between hospitals.
  • The procedures including inserting needles into major veins, drawing body fluids and performing endotracheal intubation -- a technique for opening a person's airway.
  • Doctors who support the practice say it is the best way to learn life-saving emergency procedures.

There are no hard numbers on how many hospitals engage in these practices, and the ethical policies governing such training vary widely between hospitals and even among departments within a single hospital.

Sometimes patients' insurance companies are billed for procedures used for training purposes -- and that can amount to hundreds of dollars. Some insurers say they are not aware of that, while others say these practices need aboveboard discussion.

Source: Paul Glader, "Doctors Question Use of Dead or Dying Patients for Training," Wall Street Journal, November 12, 2002.

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