A practical approach to teaching medical ethics

Abstract

Teaching medical ethics and law has become much more prominent in medical student education, largely as a result of a 1998 consensus statement on such teaching. Ethics is commonly taught at undergraduate level using lectures and small group tutorials, but there is no recognised method for transferring this theoretical knowledge into practice and ward-based learning. This reflective article by a Sheffield university undergraduate medical student describes the value of using a student-selected component to study practical clinical ethics and the use of a clinical ethics checklist. The ethical checklist was proposed by Sokol as a tool for use by medical staff during the ward round to prompt the consideration of important ethical principles in relation to care. This paper describes additional uses for the checklist as a tool for teaching and learning about the practical application of ethical principles and for observing professional behaviours within a critical care and acute care environment. Evidence suggests that putting ethical behaviour into practice offers a far greater challenge to a newly qualified doctor than has been appreciated, and that more needs to be done at an undergraduate level to help combat this. This paper argues from a personal standpoint of an individual student experience that this can best be done in a clinical medical setting.

Engaging Tomorrow’s Doctors in Clinical Ethics: Implications for Healthcare Organisations

“…The students also anticipated how learning about clinical ethics during their medical degree would benefit them in their future clinical careers as they had been given the opportunity to develop their decision-making skills, and appreciated the value of discussing ethical matters with a multidisciplinary team. We infer from these statements that by our students engaging in clinical ethics activities we have encouraged the transmission of ethics knowledge into practice settings, although we do accept that our results are reporting students’ thoughts, attitudes and beliefs rather than observed behaviour [ 26 ]. Our findings challenge those who question value, purpose, and role of ethics training [ 17 , 28 ].…”

“…As an organisation itself, the current and future practitioners are likely to be ethically sensitive and aware, with enhanced decision-making skills, and a tool kit to draw upon when facing ethical cases in practice. They are therefore able to inform practices and influence the culture within the NHS [ 26 ]. They are also likely to appreciate the value and importance of gaining insight into multiple perspectives when discussing ethical aspects of cases with a range of professionals.…”

“…We chose frameworks that were accessible to all vocations involved in the interprofessional clinical ethics forums, and were known to be used by qualified practitioners such as C.A.R.E. [ 39 ], as we hoped to encourage the translation of ethics knowledge into practice settings [ 26 ]. Finally, as a range of facilitators were involved in the clinical ethics activities, including practitioners and academics, we chose frameworks that allowed both clinical- and classroom-based educators to be involved in the teaching of ethics [ 12 ].…”

Revising curricular on medical ethics: a way forward

“…Further, gathered knowledge and skills of a medical student on ethics should be strengthened every day in the ward setting. Bed side teaching of bio ethics in each discipline gives holistic attitude to the problems where the learner can interact with the patient while learning emotional, social and cultural attributes of ethics 30 . Continuous professional development programmes for academics and clinicians have to be strengthened by providing training with the aim of integrating ethics teaching routinely at the bed side.…”

Case-Based Teaching of Ethics Ethical Challenges Raised by Undergraduate Medical Students during a Bioethics Course (What Students Bring to the Classroom?)

“…Recently, it has been realized that teaching ethics will be more appealing if taught in a learner-centered format (Loike et al, 2013;Mills & Bryden, 2010). Based on this idea, several methods have been used for teaching ethics to medical students in attempts to motivate students and engage them in the learning process.…”