Commentary: Moral growth in medical students

Brody, Howard; Squier, Harriet A.; Foglio, John P.

doi:10.1007/bf00998146

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…At our home institution, students in the clinical years frequently reported high levels of frustration, anger, disillusionment, helplessness and even despair resulting from an environment often perceived as more abusive than supportive (Brody et al, 1995). From a faculty perspective, there was insufficient opportunity in the curriculum to adequately discuss attitudes, strategies and skills for dealing with the many difficult situations that arose.…”

Section: Course Descriptionmentioning

confidence: 99%

Teaching the art of doctoring: an innovative medical student elective

2006

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The authors describe a longitudinal third-and fourth-year elective, 'The Art of Doctoring', introduced in an attempt to counteract perceived frustration and cynicism in medical students at their home institution during the clinical years. The course goals aimed at helping students to develop self-reflective skills; improve awareness of and ability to modify personal attitudes and behaviors that compromise patient care; increase altruism, empathy and compassion toward patients; and sustain commitment to patient care, service and personal well-being. These goals were accomplished through introduction and development of five skill sets: learning from role models and peers; on-site readings of works by medical student-and physician-authors; self-and other-observation; self-reflective techniques; and case-based problem-solving. The course involved regular in-class exercises and homework assignments, as well as a personal project related to improving personal compassion, caring and empathy toward patients. Students also learned to use a coping algorithm to approach problematic clinical and interpersonal situations. Class discussions revealed three issues of recurring importance to students: loss of idealism, non-compliant patients, and indifferent, harsh or otherwise unpleasant attendings and residents. Quantitative and qualitative student evaluations overall indicated a generally favorable response to the course. Problems and barriers included attendance difficulties and variable levels of student engagement. Future directions for this type of educational intervention are considered, as well as its implications for medical education.

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Section: Course Descriptionmentioning

confidence: 99%

Teaching the art of doctoring: an innovative medical student elective

2006

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“…It is important for patients to be made aware that refusal to provide the requested course of action does not represent the physician's revulsion for the person requesting the service but rather a sincere concern about how the act itself may—from the practitioner's perspective—be unsuitable, imprudent, unethical, or harmful [10]. Furthermore, some critics suggest that acquiescence by the practitioner without being forthright may facilitate guilt and shame for the health provider [37, 104]. …”

Section: Making Decisions In the Face Of Ethical Collisionmentioning

confidence: 99%

Ethical Diversity and the Role of Conscience in Clinical Medicine

Genuis

Lipp

2013

International Journal of Family Medicine

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In a climate of plurality about the concept of what is “good,” one of the most daunting challenges facing contemporary medicine is the provision of medical care within the mosaic of ethical diversity. Juxtaposed with escalating scientific knowledge and clinical prowess has been the concomitant erosion of unity of thought in medical ethics. With innumerable technologies now available in the armamentarium of healthcare, combined with escalating realities of financial constraints, cultural differences, moral divergence, and ideological divides among stakeholders, medical professionals and their patients are increasingly faced with ethical quandaries when making medical decisions. Amidst the plurality of values, ethical collision arises when the values of individual health professionals are dissonant with the expressed requests of patients, the common practice amongst colleagues, or the directives from regulatory and political authorities. In addition, concern is increasing among some medical practitioners due to mounting attempts by certain groups to curtail freedom of independent conscience—by preventing medical professionals from doing what to them is apparently good, or by compelling practitioners to do what they, in conscience, deem to be evil. This paper and the case study presented will explore issues related to freedom of conscience and consider practical approaches to ethical collision in clinical medicine.

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“…27 Many health professionals feel a threat to their ''freedom of conscience'' (a basic human right according to the UN Universal Declaration of Human Rights 28 ) and report a type of moral or ethical distress 29 when placed in a position of subordination to authorities who exert power to elicit choices that contravene personal values. Most health providers wish to maintain ethical standards, but it is unrealistic to expect that all individuals will act according to their principles if the cost or consequences are considered too high.…”

Section: Sequelae Of Authoritarian Guidelinesmentioning

confidence: 99%

Dismembering the ethical physician

Genuis¹

2006

Postgraduate Medical Journal

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Physicians may experience ethical distress when they are caught in difficult clinical situations that demand ethical decision making, particularly when their preferred action may contravene the expectations of patients and established authorities. When principled and competent doctors succumb to patient wishes or establishment guidelines and participate in actions they perceive to be ethically inappropriate, or agree to refrain from interventions they believe to be in the best interests of patients, individual professional integrity may be diminished, and ethical reliability is potentially compromised. In a climate of ever-proliferating ethical quandaries, it is essential for the medical community, health institutions, and governing bodies to pursue a judicious tension between the indispensable regulation of physicians necessary to maintain professional standards and preserve public safety, and the support for “freedom of conscience” that principled physicians require to practise medicine in keeping with their personal ethical orientation.

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Commentary: Moral growth in medical students

Cited by 7 publications

References 14 publications

Teaching the art of doctoring: an innovative medical student elective

Teaching the art of doctoring: an innovative medical student elective

Ethical Diversity and the Role of Conscience in Clinical Medicine

Dismembering the ethical physician

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