Ethical scenario (medical school interview question): You're a junior doctor working in A&E and are triaging a patient with a head injury. He doesn't want to see you as you're "not white", so can't be a "proper doctor". Discuss the issues raised.

The main ethical issue raised here is the need to balance the patient's autonomy and our duty to treat. 

Firstly you would need to talk to the patient. Racism is not tolerated within the NHS but it would be helpful for both you and him to find out the reason for why he thinks a doctor of an ethnic minority is not as qualified. Perhaps he's had a bad past experience. If talking alone doesn't lead to a resolution, the patient's capacity would need to be assessed. The patient's autonomy is very important, but it needs to be determined whether he is able to make the decision to refuse treatment. Is he able to understand and retain information, weigh it up, and communicate it back? If he has capacity, his refusal for treatment will be respected. It can be explained to him that he's not able to choose another doctor, but he may simply have to wait longer until another doctor is available. If he does not have capacity, for example his head injury may be affecting his cognition, he can be treated in his best interests under the Mental Capacity Act, which may mean treating him anyway.

SH
Answered by Safiya H. Medical School Preparation tutor

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