Should I do what they say to secure that grade A?

It was four weeks before my finals and I, like all my colleagues, was feverishly trying to grab what clinical experience I could get. I was on a busy geriatric firm, and I had plenty of opportunity to practise the invasive procedures that a house officer needs to survive on the wards. The elderly patients were mostly willing to “let the student have a go” and I made the most of the sessions to advance my skills. It was only when I was asked to perform a femoral arterial stab (a painful procedure) on patients who could not give consent that I began to wonder if what I was being asked to do was ethical.

One patient was comatose and the other had advanced dementia, but the doctor encouraged me to “have a go.” My mind raced at this point, torn between the conflict I felt: my natural desire to acquire clinical skills was balanced by an uncomfortable feeling that neither …