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LEARNING AND TEACHING MEDICAL ETHICS. SOME BACKGROUND. The Pond Report 1987 Tomorrow’s Doctors 1993 Consensus Statement 1998 Core content Learning and teaching methods 2000 Curricular review 2004 (2006). THE CORE CONTENT 1. Informed consent and refusal of treatment
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SOME BACKGROUND • The Pond Report 1987 • Tomorrow’s Doctors 1993 • Consensus Statement 1998 Core content • Learning and teaching methods 2000 • Curricular review 2004 (2006)
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
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
THE OUTCOME OF THE 2004 STUDY • Horizontal integration • Learning methods • Methods of assessment • Theoretical issues • Staff expertise and capacity • Leadership
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
SOME HISTORICAL REFLECTIONS • An arts degree before commencing medicine • “The Democratic Intellect” George Davie. Learning Moral Philosophy and Logic. • Could we return to this?
LEADERSHIP • Capacity- people • Capability- expertise and skills • At all levels-integration in the curriculum
PEOPLE • Building capacity • Learning sets, mentoring • Career progression and structure • Faculty of Medical Education
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
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 one’s own values • Ability to think through the issue-logic and argument • Recognition of uncertainty-limits to knowledge
INTEGRATION OF LEARNING • Across all parts of the curriculum • Cohesive • Not necessarily all in agreement!
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.
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
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
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?
CONCLUSIONS • We can do better • The key is investment in people • Science AND the arts and humanities together