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Teaching values to medical students?

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Teaching values to medical students? Prof.dr.R.Rubens Dept Endocrinology University Gent Medical ethics in the curriculum Tradition: Hippocrates, Galenus, Positivism ... – PowerPoint PPT presentation

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Title: Teaching values to medical students?


1
Teaching values to medical students?
  • Prof.dr.R.Rubens
  • Dept Endocrinology
  • University Gent

2
Medical ethics in the curriculum
  • Tradition Hippocrates, Galenus,
  • Positivism XIX century
  • Revival end XX century
  • medical deontology regulations, etiquette,
    corporative tradition, legal obligations.
  • Medical ethics ? based upon deontological or
    consequentalistic ethical theory

3
Aims of medical ethics
  • To teach physicians to recognize the humanistic
    and ethical aspects of medical careers.
  • To enable physicians to examine and affirm their
    own personal and professional moral commitments.
  • To equip physicians with a foundation of
    philosophical, social and legal knowledge.
  • To enable physicians to employ this knowledge to
    clinical reasoning.
  • To equip physicians with the interactional skills
    needed to apply this insight, knowledge and
    reasoning to human clinical care.
  • Miles et al Academic Medicine198964705-14

4
Consensus of Expectations of teaching medical
ethics
  • In a pluralistic society no single moral
    viewpoint.
  • Does not create a sound moral character .
  • Equip young students of sound character with
    knowledge and skills required to practise good
    medical care.
  • No simple solution to the deshumanising aspects
    of modern technological medicine
  • Goldie J. Medical Education 200034108-119

5
Principilism and Prima Facie
  • Autonomy Locke, Kant
  • Benificence Asoka, Christ, Seneca, Maimonides.
  • Non-Maleficence Hippocrates
  • Justice. WW II
  • Beachamp TL, Childress JF Principles of
    Biomedical Ethics, 5th Ed, OUP, 2001

6
De Camp/Gillon recommendations for content of
medical ethics course
  • Moral aspects of medical practice
  • Valid consent or refusal .
  • Patient is partially or fully incompetent
  • how to proceed if patient refuses treatment.
  • The ability to decide when it is morally
    justified to breach confidentiality
  • Knowledge of the moral aspects of caring for the
    patient whose prognosis is poor.
  • Culver et al NEJM1985312253-256
  • Gillon R., JME199622323-324

7
Goal of medical ethics education
  • Creating virtuous physicians ? decline in moral
    reasoning
  • Training in skills of ethical analysis
  • Empirical results negative Kohlberg progression

8
Teaching Methods
  • Ethicist ? Physician
  • Integrated
  • Lectures ? Small group discussions
  • Cases or Film
  • Student centered
  • Progressive

9
Gent system
  • First year Lectures 6 hour, 2 hour group
    discussion, 6 hours small group discussion basic
    principles, standard problems written exam
  • Third year lecture 2 hours experiments on
    humans MCQ questions
  • Fifth year Interactive lectures about legal,
    deontological and ethical aspects(16 hours)
  • Sixth year four days interactive discussion
    choice of care, medical incidents, genetics,
    beginning and end of life.
  • Seventh year Additional guest lectures (10
    hours) and writing of critical paper about
    ethical subject

10
Conclusions
  • Medical ethics is a central and obligatory part
    of a medical curriculum.
  • Medical ethics cannot by itself give the correct
    sense of morality necessary for the medical
    profession.
  • Medical ethics can learn students to analyse
    ethical problems.
  • Medical ethics can confront the analysis of the
    clinical problem with human rights.
  • But Best training is the visibility of the
    virtuous physician or rerum omnium magister
    usus(the habit is the master of all things)
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