Making Sense of Medical Ethics: A hands-on guide PDF

PREFACE

Dame Janet Smith, chair of the Shipman Inquiry, called for a greater emphasis on ensuring that medical students are aware of professional ethics early in their training, and even suggested that medical students who fail to demonstrate ‘ethical sense' should not be allowed to qualify (Smith, 2005). On the other hand, David Sokol points out that it is ‘unrealistic to expect medical students to learn more than the bare bones of the subject', given that their curriculum is already overloaded, or to expect junior doctors to undergo extensive training in medical ethics, while working full-time (Sokol, 2005). This book is written to resolve this paradox. Asking students to learn rules, without understanding how or why they came about, goes completely against current methods of medical education. Instead, to make sense of this difficult subject, we need to highlight the key issues, clarify confusions, and provide a clear and logical framework for ethical decision making.

We start by defining the subject and exploring some of the misunderstandings surrounding medical ethics. We then outline the main ethical theories and explain how the different value systems and world-views inform ethical thinking and decision-making. Our approach throughout, however, is practical rather than purely theoretical, and the examples throughout the book are nearly all based on real clinical situations. We then discuss if, and how, a professional consensus can be reached and identify how law and ethics interact. As well as analysing in detail the five main ethical principles, we show that they are often in ‘competition'. We suggest ways in which this competition can be resolved and how ethical priorities can be established. We demonstrate the use of an algorithm in making ethical decisions in a variety of different situations.

The last two chapters emphasize particular ethical dilemmas faced by students (including examinations!), and ask ‘What makes an ethical doctor?' Throughout the book, we challenge readers to examine their own values and to be clear why we even care for sick people in the first place.

The book does not aim to cover every topic systematically; some are mentioned in several different sections to illustrate different principles and algorithms, so the index and further reading guides need to be used. Although the book is aimed primarily at medical students and junior doctors, we have made it accessible to many other health care and lay groups. We hope we have not only made sense of medical ethics, but also stimulated a long-term practical interest in this engrossing and important subject.