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http://dailynews.yahoo.com/h/nm/20010323/hl/ethics.html
Med Students Face Ethical Dilemmas, Study Finds
NEW YORK (Reuters Health) - Although there is a growing emphasis on ethical studies in medical schools, once they are in the trenches, doctors-in-training often feel pressure from their superiors to act unethically, according to a report.
Medical student David Robertson from the University of Toronto in Canada and his more senior colleagues engaged 108 medical students in a study of the ethical dilemmas they faced while in training.
Nearly half of the students said they had felt pressure to act unethically at least on an occasional basis, the authors report in the March 24th British Medical Journal. An even greater proportion--61%--had witnessed unethical acts committed by one of their clinic teachers.
The ethical dilemmas students faced affected the foundation of patient care. For example, some students were instructed to perform pelvic or rectal examinations on patients under general anesthesia who had not given their consent for such exams.
Moreover, students were sometimes asked to give medical care they felt unqualified to give--including performing a prenatal exam or giving weekly psychotherapy without any supervision.
In addition, several students cited examples in which they had provided substandard medical care, such as giving painkillers to a woman in labor who had requested she receive no drugs.
``We hope that by learning to recognise and explore these ethical dilemmas, medical educators will be able to expose, and ultimately dismantle, deleterious aspects of the 'hidden curriculum' which currently hinder the ethical growth of medical students,'' the authors conclude.
Dr. Len Doyal of the Royal London School of Medicine and Dentistry, UK, proposes moving beyond hope to policy. In an editorial, Doyal outlines a policy designed to eliminate the unethical practices cited in the report--including getting patients' ``explicit verbal consent'' before students can examine them.
Implementing such a policy, Doyal writes, ``requires the development of the moral character necessary for hospitals and medical schools to become sanctuaries of respect for human rights and dignity.''
Dr. Andrew West and colleagues from Oxford, UK, share this view. In their commentary, the doctors write, ``The medical profession urgently needs to learn respect for the living and for the dead, and thereby earn the public respect that is its lifeblood.''
SOURCE: British Medical Journal 2001;322:709-710, 685-686, 743.
Med Students Face Ethical Dilemmas, Study Finds
NEW YORK (Reuters Health) - Although there is a growing emphasis on ethical studies in medical schools, once they are in the trenches, doctors-in-training often feel pressure from their superiors to act unethically, according to a report.
Medical student David Robertson from the University of Toronto in Canada and his more senior colleagues engaged 108 medical students in a study of the ethical dilemmas they faced while in training.
Nearly half of the students said they had felt pressure to act unethically at least on an occasional basis, the authors report in the March 24th British Medical Journal. An even greater proportion--61%--had witnessed unethical acts committed by one of their clinic teachers.
The ethical dilemmas students faced affected the foundation of patient care. For example, some students were instructed to perform pelvic or rectal examinations on patients under general anesthesia who had not given their consent for such exams.
Moreover, students were sometimes asked to give medical care they felt unqualified to give--including performing a prenatal exam or giving weekly psychotherapy without any supervision.
In addition, several students cited examples in which they had provided substandard medical care, such as giving painkillers to a woman in labor who had requested she receive no drugs.
``We hope that by learning to recognise and explore these ethical dilemmas, medical educators will be able to expose, and ultimately dismantle, deleterious aspects of the 'hidden curriculum' which currently hinder the ethical growth of medical students,'' the authors conclude.
Dr. Len Doyal of the Royal London School of Medicine and Dentistry, UK, proposes moving beyond hope to policy. In an editorial, Doyal outlines a policy designed to eliminate the unethical practices cited in the report--including getting patients' ``explicit verbal consent'' before students can examine them.
Implementing such a policy, Doyal writes, ``requires the development of the moral character necessary for hospitals and medical schools to become sanctuaries of respect for human rights and dignity.''
Dr. Andrew West and colleagues from Oxford, UK, share this view. In their commentary, the doctors write, ``The medical profession urgently needs to learn respect for the living and for the dead, and thereby earn the public respect that is its lifeblood.''
SOURCE: British Medical Journal 2001;322:709-710, 685-686, 743.
