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Duke-NUS graduate medical school "Moral and ethical dilemma"

ftt608 4 / 11  
Nov 17, 2011   #1
"MD Essay 4: Moral and Ethical Dilemma
What is the most significant moral or ethical dilemma that you have faced in your life thus far, excluding academic dishonesty? Describe how you dealt with and potentially resolved it, including personal and societal beliefs, ethical/ philosophical principles, resources, individuals, etc. How did this dilemma and its resolution change your life? What impact will this have on your future as a healthcare provider?" (no word limit given, hence the length...Please advice on how to cut the length)

All suggestions, corrections, critics are welcome! Thanks in advance.


During my four years of being a teacher, one question that I frequently ask myself is "should I do this as a good teacher?" I ask this question not to be regarded as a good teacher by my students or colleagues or superiors; I ask this question because as a teacher, I want to make sure that everything I do is worthy of my students' trust. Most of the times I can get the answer easily because many things we do are easily justifiable as being good or not good for students. However, there was once that I could not answer this question to myself.

Every end of semester, I need to give conduct grades to my students for their behaviour in school over the semester. It is a very routine task and we have a few indicators which help us easily identify what grade should be given to a particular student. The indicators include general behaviour, punctuality, attitude and a few others. One ordinary afternoon near the end of a semester, the school counsellor came to me and asked me about the "fair" grade that I gave to a student. "Oh yes, he was late for twelve times this semester - absolutely a 'fair' grade." I answered. "But he is on financial assistance which requires him to obtain at least a 'good' grade to continue receiving the money to pay for his school fees!" The counsellor told me. She was right, but whether a student is under financial aid or not should not affect our decision on the conduct grades. I looked at her for a few seconds before she start talking again in a lowered voice:" I suggest that you just go and change it to a 'good'. It will make things much easier and he won't lose the financial aid."

After she left, I took out my file and checked through that student's record again. He was indeed twelve times late for school. Every time he gave the same reason of waking up late. In fact I have spoken to the parents about this issue but the parents woke up even later than him. I gave him an alarm clock and asked him to set two alarms. I had also asked several of his friends to take turns to call him in the morning but he often refused to answer the call. His house is not too far away from the school, so it was very clear that the problem is his attitude - he did not take it seriously and make the effort to come to school on time. However, if I give him a "fair", he would lose his financial aid for one whole semester or even longer (if he fails to regain a "good" grade in next semester). How is the family going to pay for his school fees? There were three children in his family but only his father was working. It would be a hard time for the family without the financial aid. Am I being too harsh to him? Aren't teachers supposed to be compassionate? Will the family complain to school management that I am not a caring teacher? Probably such things had happen before and what the counsellor suggested to me was the usual solution which seemed to be good for everyone. On the other hand, what if I change the "fair" to a "good"? Should I feel happy because I saved his financial aid? I might be happy for his family because they don't have to worry about the school fees, but other than that, I would have a lot of worries. First of all, I don't think a responsible teacher should give a student a "good" grade which he does not deserve. If I can freely change the grade, the whole grading system will lose its meaning and I am not being fair to other students who put in their effort in behaving well in school. Secondly, by giving him a "good" and letting him to continue receiving financial aid, I fear that he will take many things for granted. The purpose of financial aid is to encourage students from low-income families to behave well and work hard so that they can be rewarded in such a way. If this student gets the financial aid despites his unsatisfactory behaviour, he would think that the financial aid is a right with no obligation. It is very likely that he will continue to come to school late frequently in the subsequent semesters and years without realizing the importance of being punctual. In either ways, there is going to be further problems that are difficult to solve.

I thought about it over and over again for many days until the deadline of submission. On the webpage of students conduct grades, I clicked his, deleted the fair, and typed in g-o-o-d.

Then I clicked "cancel".

In his report card, his conduct was "fair".

I had a long talk with him. I explained to him why I gave him this grade and that he would lose his financial aid next semester. I told him that he must learn to be punctual in next semester so that he can get at least a "good" to regain his financial aid. I gave him another alarm clock and asked him to work out a plan to wake up on time starting from one week before next semester starts. I also gave him a name card of the manager of a nearby fast food restaurant, who will offer him a part-time job during the holidays. With this job, he should be able to earn enough money to pay for his school fees next semester. I told him that it is ok if he hates me, as long as he can learn from his past mistakes and become more responsible for his own behaviour, it's worth it. After all, I did not change it in the end because I wanted to be responsible for him, for other students, and for myself. I did not want him to take things for granted and I wanted him to face the consequence of his own behaviour this time. Without the financial aid, there are still other ways to get his school fees paid; however, if I did the change, the damage to his responsibility and mindset may not be that easily reversible.

This incident taught me that I should not only focus on the short-term gain or loss, but to look at things in long term - bring out the best in the long run. As a future healthcare provider, I will also apply the same principles which I believed for many years: make sure that everything I do is worthy of the patients' trust. When making decisions, do not only look at the immediate effects, but also long term effects, and decide what is best for the patient, while trying my best to help them in every way I can.
EF_Susan - / 2,364 12  
Nov 21, 2011   #2
Probably such things had happened before and what the counselor suggested to me was the usual solution which seemed to be good for everyone.

Good essay and great answer to the prompt. Have fun in school and good luck!
OP ftt608 4 / 11  
Nov 27, 2011   #3
Thank you again Susan for your hardwork! Could you look at my Personal Statement and give some comments? I had a really hard time writing that and so far did not get much advice on that. Thank you!

Please look at my revised version which I posted on Nov 17.

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