LEARNING AND TEACHING MEDICAL ETHICS

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• LEARNING AND TEACHING MEDICAL ETHICS

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SOME BACKGROUND

• The Pond Report 1987
• Tomorrows Doctors 1993
• Consensus Statement 1998
• Core content
• Learning and teaching methods 2000
• Curricular review 2004 (2006)

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THE CORE CONTENT 1.

• Informed consent and refusal of treatment
• The clinical relationship, truthfulness, trust
  and good communication
• Confidentiality and good clinical practice
• Medical research
• Human reproduction

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THE CORE CONTENT 2.

• The new genetics
• Children
• Mental disorders and disability
• Life, death, dying and killing
• Vulnerabilities created by duties of doctors and
  medical students
• Resource allocation
• rights

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THE OUTCOME OF THE 2004 STUDY

• Horizontal integration
• Learning methods
• Methods of assessment
• Theoretical issues
• Staff expertise and capacity
• Leadership

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CONCLUSIONS AT THIS STAGE

• We have come a long way
• Clarity of the purpose of learning about medical
  ethics
• Need for capacity and capability
• Methods of learning and assessment
• The theoretical base

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SOME HISTORICAL REFLECTIONS

• An arts degree before commencing medicine
• The Democratic Intellect George Davie. Learning
  Moral Philosophy and Logic.
• Could we return to this?

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• SO WHAT WOULD I DO NOW?

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LEADERSHIP

• Capacity- people
• Capability- expertise and skills
• At all levels-integration in the curriculum

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PEOPLE

• Building capacity
• Learning sets, mentoring
• Career progression and structure
• Faculty of Medical Education

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THE PURPOSE OF THE CURRICULUM
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CLARIFYING THE PURPOSE

• Learning what is a moral issue?
• What is the process of analysis and argument?
• How do I express my values and judgements?
• How do I deal with disagreements?
• How do I test my views against others

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LEARNING ABOUT ETHICAL ISSUES REQUIRES.

• An understanding of the issue-the science and
  knowledge base
• An understanding of ethical frameworks and
  principles-not just case studies and anecdotes
• An understanding of ones own values
• Ability to think through the issue-logic and
  argument
• Recognition of uncertainty-limits to knowledge

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INTEGRATION OF LEARNING

• Across all parts of the curriculum
• Cohesive
• Not necessarily all in agreement!

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THE THEORETICAL BASE

• Essential-just like anatomy, physiology and
  pathology in understanding the issues
• But how should it be learned?
• Leadership in medical ethics. Teachers who
  facilitate learning and have expertise
• The use of language.

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• THE ROLE OF THE ARTS AND HUMANITIES

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METHODS OF LEARNING AND ASSESSMENT

• Debate and discussion
• Problem based
• The theoretical dimension
• Assessment of learning
• analysis of a problem
• clarity in presentation-argument
• and logic
• reflection on own values

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A MODELFor learning

• THE THREE DIMENSIONS
• Knowledge and certainty---
• uncertainty and lack of knowledge
• Social values---personal values----professional
  values
• Argument, analysis and logic----feelings and
  prejudice

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THE MODEL

• Do I know enough about this issue and the science
  behind it-eg stem cells, artificial
  reproduction?
• Do I recognise what values are relevant here, and
  am I different from others?
• Can I rationally analyse the problem and examine
  my prejudices?
• And finally, is my decision defensible?

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CONCLUSIONS

• We can do better
• The key is investment in people
• Science AND the arts and humanities together