‘Unauthorized Practice’: Regulating the Use of Anesthetized, Recently Deceased, and Conscious Patients in Medical Teaching

Abstract

This article examines the frequency with which patients are used as teaching tools without permission. It examines core assumptions underlying some physicians' belief that unauthorized practice is necessary for graduate medical education. This article suggests that this turn of the century practice persists in part because the ordinary mechanisms employed to regulate behavior — tort law and regulatory oversight — cannot effectively deter unauthorized practice. This is because the patients involved are in the worst possible position to know a dignitary violation has occurred; they are often unconscious or dead. Moreover, medical educators use patients in ways that leave few visible signs. This article argues that the most effective way to end this unauthorized practice is not through piecemeal state-by-state legislation, but with new federal regulations governing the receipt of graduate medical education funds and payment for healthcare services. Such regulations would allow a patient to feel confident in her expectation that she will not be used as a “training dummy” without her consent.