The teaching medical ethics and professional conduct at the undergraduate level
Gonzalo Herranz. department Bioethics, University of Navarra
discussion paper the congress Professional Ethics Committees: teaching Medical Ethics and Deontology
Valencia, 1992
1. The spirit of the discussion paper
2. The new curriculum: a turning point
3. The lasting impact of the licentiate degree programs of study
4. The Unattainable Ideal of Bioethics
5. The Legitimacy of Institutional Ethics as subject a Course on Medical Ethics
II. The Return of Medical Ethics and professor Conduct from Their Long Exile
1. The Code: A Guide to internship Wisdom
3. Can the Code serve as a suitable foundation for the Study program medical ethics?
IV. The Responsibilities of Institutional Ethics
In this first discussion paper teaching medical ethics and deontology,” I will focus on the undergraduate level. My presentation will be guided by a purpose : to recommend the Code of Medical Ethics and Deontology of the Medical Association as a core component of medical teaching for licentiate degree students.
1. The spirit of the discussion paper
I hasten to point out that this recommendation is phrased as a suggestion, not a demand. For I am aware that the mere content of this discussion paper could arouse suspicion—and even provoke rejection—within the academic community. Someone might mistakenly interpret our congress reflection congress the role that professional ethics should play in the licentiate degree Study program as an unjustified claim to a territory that does not belong to us, all the more so the more exclusionary their views toward professional ethics were: toward its provisions as contained in the Code or toward educational initiatives that may be undertaken by the Medical Associations or members of the Ethics Committees.
Schools medical associations each follow their own independent paths, but they are institutions that, rather than continuing to maintain a respectful mutual ignorance as they have done until now, are called upon in the future to work more closely together and to seek ways to cooperate on projects of common interest. The teaching medical ethics and deontology is one such area.
It seems to me that the boundaries are clearly defined: teaching Schools teaching is skill of universities and their Schools . The General Statutes of the Medical Association, for their part, limit the Association’s jurisdiction to licensed physicians. In principle, medical associations appear to have no business dealing with medical students and their Education; at most, they may express their opinion when requested to do so by the competent authority on the matters specifically indicated. It is, however, a readily verifiable fact that a very high proportion of medical students tend to become licensed physicians: this student-to-member continuity constitutes, in my view, a moral—rather than legal—basis that is solid and sufficient to justify the Medical Association’s having a vital and legitimate interest in the initial training that future members receive during their programs of study . This interest is specifically manifested in two points: first, that such teaching actually provided; second, that it is conducted in accordance with the Association’s code of ethics. The O.M.C. can cite a degree scroll for this interest: it has assumed before society, as one of its primary responsibilities, that of safeguarding and ensuring compliance with the deontological and socio-ethical principles of the medical profession as set forth in the General Statutes of the O.M.C. and in its Code of Medical Ethics and Deontology.
It is from this spirit that the following considerations arise.
2. The new curriculum: a turning point
The new Study program the graduate degree scroll graduate Medicine includes, among its many innovations, one that is of particular interest to us: the reinstatement of medical teaching . Starting in academic year , all Schools offer their students a formalized program in medical ethics. The general nature of the curriculum published in the bulletin does not allow for the definition of many specific aspects: Schools is Schools the Schools to establish the specific details, such as the placement of the discipline the curriculum, the scope of the program, the practical component of the new subject, and others, including the possibility of dedicating anelective subject topics of an ethical and deontological nature.
The reinstatement of Medical Ethics in the curriculum of programs of study after nearly twenty years of its absence from the Education future doctors. It is very difficult to gauge the extent to which this gap in training may have contributed to the general leave regard for ethical issues in medicine among the more than 110,000 physicians who have graduated since 1975, who constitute the majority of Spain’s medical workforce. Ethical matters—and, in general, professional association issues—enjoy little popularity among them, both in their individual views and within the environment of the healthcare institutions where they work. It will not be easy to remedy the indifference of all these generations of doctors toward the O.M.C. and its Code of Medical Ethics and Deontology, but it is a task worthy of the utmost effort, which Professor Diego Gracia will address in a few moments in the second part of this discussion paper. What concerns us immediately is how we can take advantage of the opportunity presented by the reintroduction of Medical Ethics into the Study program. May this be the starting point for a promising future!
3. The lasting impact of the licentiate degree programs of study
I would like to highlight a fact that we rarely emphasize, but which, in a way, supports the argument that professional ethics should form the core of the medical discipline in the licentiate degree curriculum: that the training during the licentiate degree program, despite its undeniable shortcomings, tends to foster long-lasting intellectual habits and moral attitudes. It seems to me that during our years in medical school, we have all acquired, to a greater or lesser extent, knowledge and skills belonging to two different spheres: on the one hand, data and how to handle it; on the other, ethical attitudes. It is almost paradoxical that the most enduring elements are not data of the Basic Sciences of pathology and therapeutics—which, in vast quantities, have been the subject of teaching and programmed teaching by professors and which must be understood, or at least memorized, by the student in order to pass the exams. Today, they occupy nearly one hundred percent of the student’s learning capacity, as the test for admission to Intern and Resident positions—the spanish medical residency program exam—makes them supremely decisive. A significant portion of this data because scientific progress renders it obsolete, others because it is irrelevant to the specialization program —will be set aside as report or will soon be forgotten through a process of erasure by disuse. What our time at the University provides us with lasting value are things that are not usually taught deliberately, things difficult to convey through formal lessons or the study of textbooks, which are acquired ad libitum, through a process that owes more to affinity and emulation than to teaching . These are things like the habit of critical study, that of posing problems and trying to solve them, and respect for others—things we learn from some professors or that some classmates teach us: some are inferred from the way a professor expresses themselves; others are discovered in the way a professor conducts themselves professor of patients; others are acquired simply through daily interaction.
Today, there is little confidence in the power of character to influence character, or in the power of example as a means of training and human training for students. Not everyone is open to influence. Few choose a teacher as model . Due to a lack of sensitivity, idealism, or a true calling, the impact—whether explicit or implicit—of the ethical gestures and human demeanor of teachers best suited to serve as role models is weakened or fails to materialize. Moreover, many young teachers deliberately refrain from acting as ethical agents. For these and other reasons, we must conclude that example and environmental influence are insufficient to provide all students with basic training . Therefore, the teaching of Medical Ethics and Deontology, by virtue of its specific moral character, can act as a bridge facilitating the exchange between these two worlds—between the cultures of objective science and personal virtues—and thus help students discover the universe of ethical and professional values.
A question frequently raised among teachers of medical ethics is whether, in contrast to example and environment, having studied ethics and deontology makes a physician different—presumably better—and whether it has a practical and lasting effect on their professional conduct. I have already mentioned the fact that tens of thousands of Spanish physicians, who graduated in the last fifteen to thirty years, work in all fields and specialties of internship without having received Education in the subject. No one has measured their level of ethical conduct or compared it with that of physicians from earlier eras. There is no data demonstrate whether the teaching medical ethics and deontology has a measurable effect on physicians’ behavior. It seems enormously difficult, if not impossible, to design a research to determine whether there are differences—and what they are—in the behavior of physicians who are ignorant of or knowledgeable about deontology. But, as Pellegrino astutely points out, we also lack data regarding the role played by other components—apparently indispensable ones—of Study program the physician’s scientific conduct. No one has demonstrated whether there is a correlation between the teaching Anatomy Biochemistry the scientific quality of internship . The composition of Study program based, it must be admitted, on very sensible, reasonable, and well-considered assumptions, but which, at their core, are nothing more than acts of faith: we are all convinced that good medicine must be based on the scientific method and that severing medicine from its commitment to science would be an irreparable loss, leading to its regression to marginal and heterodox forms. Similarly, we can accept as axiomatic the notion that knowledge and the sincere adoption of conduct guided by medical ethics foster a more upright and competent practice of medicine. Although having studied ethics does not guarantee anyone a virtuous life, it is undeniable that, if such study were to provide the capacity to rationally form one’s own conscience, its practical effects on one’s moral life would be profound and lasting.
One might therefore suspect that teaching in ethics and professional conduct could be financial aid great financial aid students. When, upon completing their programs of study, they register their names on the professional association’s roster, they are suddenly vested with all the rights and obligations that membership confers or imposes. They find themselves almost suddenly required to act, in the presence of their patients, colleagues, and superiors, as mature, responsible adults. And, as we all know from experience, the lack of training leaves them terribly vulnerable in their newly assumed role as independent and accountable professionals. That is why, I insist, medical ethics is a discipline extraordinary practical value, one that produces real, everyday effects. Professional ethics can save the young physician from being bullied by institutions, by their superiors, their peers, their patients, and even by their own inexperience.
4. The Unattainable Ideal of Bioethics
The new Study program very little time to the teaching study of medical ethics. My experience over the past several years has shown me that, even in the most favorable environments, the time the curriculum allocates to medical ethics will always be insufficient. In our Schools , medical ethics will continue to be regarded for a long time to come as a discipline , one that cannot gain professor the expense of “hard” disciplines. This forces us to forego developing a comprehensive and detailed program that includes the topics of the broad discipline bioethics. This Withdrawal, though painful, is also necessitated by the fact that the knowledge of fundamental ethics that students bring with high school diploma quite rudimentary and, often, capriciously subjective. There is no time to adequately address issues as diverse and far-ranging as the critical analysis of the various schools of moral philosophy, nor for students to participate in the discussion of a issue of cases and problems in clinical ethics.
The limited time available designing subject modest curriculum for the subject . The scope and content of the subject must be defined realistically and without pretensions of grandeur. When I taught Anatomy to my students, I did so with great enthusiasm, but with the modest conviction that I should limit myself to showing them the Anatomy that a physician needs to know, not what a pathologist needs to know. With that same modest conviction, I believe that our students should be taught the medical ethics that a good physician needs to know, not what a moral philosopher who devotes themselves to it full-time needs to know. And that goal—modest yet fundamental—can be achieved if the subject of the medical ethics course consists of presenting and discussing, with enthusiasm and clarity, the Code of Medical Ethics and Professional Conduct, its foundations, and its articles.
5. The Legitimacy of Institutional Ethics as subject a Course on Medical Ethics
One might object that the Code’s recommendation as a core component of medical teaching in Schools could constitute a serious limitation—if not an outright attack—on Chair freedom. One might even argue that it amounts to sponsor particular school of thought, or that it is a maneuver to impose the corporate interests of the WMA and thereby perpetuate its control over the practice of the profession. The Code would thus become a sort of catechism through which the WMA extends its influence over the student catechumens who will become its future members.
These objections are not difficult to refute. I would like to point out, to begin with, that when I recommend the Code as the guiding principle for a course in medical ethics, I am not imposing any dogmatic or exclusive doctrine. For years, I myself have oriented my program toward a general course in bioethics. And if, not without pain and hesitation, I had to abandon it, it was not for internal reasons related to the content and structure of my bioethics program, but because the students showed, year after year, little receptivity to a program solidly grounded in moral philosophy. In the fifth year of their programs of study , the vast majority of students have a universe of interests that is already very rigidly fixed, terribly utilitarian, in which nothing that is not immediately applicable finds a place. It was precisely in search of realism and practicality that I changed my Bioethics program to one of Medical Ethics and Deontology. We must humbly acknowledge that the ethics of the Code, as discipline , is a very crude product: it is, in truth, a hybrid—practical and realistic, eclectic and unsystematic—that does not inspire admiration among philosophers. I am certain that very few, if any, professional philosophers, were they invited to teach a course in Ethics for medical students, would choose the Code as guideline their teaching.
In an effort to get to the heart of the matter, and after acknowledging that there are many very different legitimate ways to structure an ethics curriculum, I insist that the Code’s recommendation does not infringe upon academic freedom, because it is not only a legitimate way to address the challenge of selecting a curriculum for the subject, but also an excellent way to do so. The accusation of institutional, corporatist partisanship, made in the name of ethical pluralism, is false. For it is paradoxical that someone, in the name of pluralism, would deny citizenship to yet another strand of the ideological rainbow. There are people who seek to solve the problems of ethical pluralism with a poor, synthetic, minimalist, and eclectic product: a sort of doctrine for moral eunuchs. But, we must acknowledge, a neutral, aseptic, disembodied medical ethics is not possible. Any system of ethical norms offered as an alternative (from the minimalist and consensual to the fundamentalist or decreed) is necessarily informed by certain specific convictions—or by a lack thereof. Given the choice, the Code of Medical Ethics and Deontology is as good a framework as any other, with the added advantage that codes very similar to ours inspire and guide the conduct of physicians in all advanced countries, and have inspired many generations of physicians of high moral standing.
II. The Return of Medical Ethics and professor Conduct from Their Long Exile
If internship planned reform of Study program is internship —which, despite some civil service examination the lecture , is, according to the bulletin , inevitable—medical ethics will once again be taught in our Schools. This is almost a challenge. By October 1993, each faculty must have in place theprofessor for teaching discipline, must have determined the professor load professor to theoretical and practical classes, and must have a decent library collection available.
I believe that the Medical Associations—and, more specifically, their Ethics Committees—should work closely with Schools and their Departments forensic medicine to revitalize the teaching of medical ethics. This is a selfless and altruistic effort of support upon which the effectiveness professor the proper direction of this revitalized discipline may depend. Indeed, there is a remote risk that the big fish will eat the little fish—that Forensic Medicine will absorb Medical Ethics.
This integration can occur on two levels. On a purely practical level, it involves issues related to professor scheduling: course load, and the allocation of human and material resources within the department. There is a potential problem here: Royal Decree 1417/1990 assigns a academic load (theoretical and internship) of 9 credits to therequired subject of Forensic Medicine and Toxicology, Medical Ethics, and Medical Legislation. Little time and many competitors. Whoever is in charge of teaching Ethics will have to negotiate to receive a share of acceptable proportions, commensurate with the subject importance. The other level, of a more doctrinal nature, affects the very concept of the subject Medical Ethics and its relationships with Medical Law, Forensic Medicine, and general state legislation. This is where the aforementioned risk lies: that medical ethics may see its identity threatened and, rather than being absorbed, be transformed into medical law.
I know issue forensic medicine, and I am aware of the dedication with which they have sought, throughout the prolonged academic exile of medical ethics, to ensure that professional ethics is given a dignified place in the curriculum of their discipline. I have observed that those among them who have served as members of the Central Commission on Professional Conduct and the Professional Conduct Commissions of the Medical Associations are among the most competent practitioners of the subject among the most effective advocates of medical ethics and professional conduct as discipline distinct from medical law and forensic medicine.
I therefore conclude that, in principle, the prospects for cooperation between Schools colleges are very promising. It is our responsibility to ensure that these prospects become a reality, and to that end, we must follow a collegial policy of loyal and generous cooperation that prioritizes the best Education students over individual gain, ensuring that the enlightening principles of our Code are training absent from their training . This is an opportunity and a responsibility that we cannot squander.
1. The Code: A Guide to internship Wisdom
Someone—a leading authority from a major association medical association —remarked, purpose seemingly insoluble nature of certain ethical dilemmas, that a physician is sometimes in greater need of the moral intuitions of a Greek tragedian than of the rational clarity of a philosopher. It is a beautifully put observation, but fortunately, we physicians generally operate in less dramatic circumstances. Fortunately, we do not have to face agonizing moral conflicts every day, but rather adhere in our conduct to the traditional rules of morality, keeping at hand a simple guide leads us toward the correct way to resolve common conflicts. Those simple rules and guidelines are the substance of the Code. And that is the medical ethics and deontology with which our students must become familiar: the one that will allow them to act with prudence and moral wisdom in the ordinary situations of their work, across the vast field of unproblematic yet demanding daily conduct. In more complex ethical situations, just as with indecipherable clinical cases, the logical course of action is to seek the financial aid more experienced colleagues, through enquiry of the bibliography. But, just as it is said that the attendance physician must have sufficient knowledge to successfully resolve a very high percentage of the problems presented by their patients, the general practitioner must possess Degree of professional ethics Degree that they can successfully resolve nearly all the ethical conflicts that arise. For this, a knowledge of the Code is sufficient.
The Code, despite its humble appearance—and even in its current, somewhat diminished form—is a formidable archive moral wisdom. It is founded on principles of inexhaustible ethical significance (respect for human life; reverence for human dignity, particularly in the status of the sick and the weak; the obligation to serve all without distinction, without discrimination of any subject, and to provide medical care for the community; the commitment to loyalty toward the patient, placing the patient’s interests above staff interests; the duty to refrain from causing deliberate harm, and to guide one’s actions by criteria of justice). Another of these fundamental principles is the scientific vocation of medicine, both as business and as the individual practice of the physician, which creates the obligations to conduct research in search of new discoveries, to continually review the validity of concepts to keep knowledge up to date, and to review practices and technologies in order to discard those that are useless or harmful.
These principles—and, more broadly, all the articles of the Code—cannot be taught as rigid rules issued by a distant and unchallengeable authority, but rather as criteria, imbued with vitality and prudence, upon which students and physicians must reflect. In this reflection, the principles and articles of the Code must serve not as a dead letter, but as seeds for speech , a starting point for rational decisions and conclusions that can be justified. One of the primary objectives of a course in medical ethics is to enable students to examine and justify their own personal moral commitments. I am convinced that, if the full ethical richness of the Code is effectively conveyed to them, the vast majority of students will wholeheartedly adhere to it—not out of institutional or disciplinary expediency, but out of a conviction regarding its rationality and prudence.
3. Can the Code serve as a suitable foundation for the Study program medical ethics?
This is a crucial question. It would be inappropriate to recommend the Code if it were unable to provide an adequate foundation for a medical ethics course that, within the scope—as measured in credit hours—set by academic authorities, aims to achieve highly ambitious educational goals. If the Code were to fall short of those aspirations, we would find, at the very least, that it would act as a hindrance to the effective teaching medical ethics, and the proposal would therefore have to be withdrawn.
Before I begin to answer the question, I would like to make a clarification. I like to think of the Code as a living book. I recognize that some who approach it with an overly critical attitude or political biases may find it foolish, dry, illusory, or useless. But when enquiry integrity, it sample of content, provided that reading it is accompanied by reflection. Undoubtedly, it sometimes disappoints due to its omissions, but, generally speaking, it almost always serves as guide inspiration for the physician’s conduct. I am convinced that the analysis and internship the Code’s articles can substantially enrich the practice of medicine, both for individuals and for the medical profession as a whole. At a lower ethical level, it prohibits or discourages certain behaviors, and threatens, in accordance with the General Statutes, to punish the commission of certain actions: it is necessary and legitimate for a code of ethics to contain prohibitions if it is to seriously ensure that professional ethics do not fall below a certain threshold. The Code is also expressive in its silences, although not all its omissions are of the same nature: some are a testament to tolerance in the face of divergent ethical opinions among physicians; others indicate that the time has not yet come to set the limits of professional good conduct, either because solutions to ethical problems are still being explored, or because these problems have not yet been fully articulated in all their scope. It is to be hoped that in its successive editions, gaps will be filled, omissions remedied, and defects corrected. The solution often lies in reviving articles from drafts and previous versions, or in decisively introducing new thematic material. The biannual review provides frequent opportunities for improvement. Just as I hope the Code can help shorten the period during which medical ethics remains in its infancy as discipline , I am certain that the use of the Code in the teaching medical ethics can be an interesting source suggestions for improving it.
The Code’s strength does not lie in its negative rules—which prohibit certain actions—or in its omissions, but rather in its affirmative prescriptions, which encourage virtuous action and show physicians the vast landscape of options for dignity and professional virtue, where they can resolve situations beyond mere ethical or legal minimums and provide their services with a commitment that goes far beyond the bare minimum. It is precisely in this area that the Code is particularly valuable as a program of medical ethics and as guideline fostering humanity in students.
It is said that the goal of Education for medical students is to prepare them to acquire, with a view to their future work physicians, the maximum amount of internshipwisdom, internshipdefined as the rational capacity to perceive and respond to the human and ethical values of professional practice. To this end, it is necessary that, apart from strictly informative objectives, teaching achieve others: that students be aware that in professional practice there are ethical and human components they must learn to identify; that they learn to apply the Code’s standards to clinical situations and realize that this process almost never yields a single answer, but rather a variety of behaviors of varying Degree moral rigor or excellence; and, finally, that, in light of the Code, they explore their personal moral convictions and subject them to critical scrutiny, so that they can always provide a rational justification for their actions beyond mere conformity to the letter of the Code. The consequence of this Education is to make future physicians, on the one hand, more discerning—that is, more capable of detecting and analyzing the ethically relevant circumstances of the cases presented to them—and, on the other hand, to learn what acceptable responses may be when ethical conflicts arise in their relationships with patients, colleagues, and the rest of society.
It is also essential that Education , based on the Code, be a widely shared ideal among the professor. Some horizontal integration is needed. Students must see that professional ethics informs their professors’ conduct. Otherwise, the seeds of that initial training for medical students could prove fruitless. They, even more so than their senior colleagues in the profession, may be led to believe that medical ethics and deontology lack solidity and objectivity, that it is a matter of opinion, and that, in general, any answer given to any problem is as valid as any other. Moral relativism is an extremely attractive temptation.
I believe that the structure of the Code can serve financial aid a financial aid that risk. To that end, it is essential that the teaching professional ethics be conducted with academic rigor. The methods used to convey relevant information (lectures, seminars, work groups) and to administer and grade exams must be as rigorous as those for any other subject in the curriculum. Without that rigor, all the professor efforts professor practically fruitless, and the benefits expected from the reintroduction of medical ethics into the Study program lost.
The reinstated code of medical ethics will face significant challenges. Preparation for thespanish medical residency program test spanish medical residency program the primary—and almost exclusive—motivation for studying among students in nearly all courses of the degree program among recent graduates who have not yet passed it. Since it seems unlikely, as things stand, that spanish medical residency program regarding medical ethics and deontology will be included in the spanish medical residency program exam question banks, it is necessary to spark interest, so to speak, against the tide. The structure and grade the exams play a very important role in this. The function of the exam cannot be limited to measuring the student’s knowledge on the day of the test. The exam must also serve to demonstrate to students that medical deontology is just as worthy of study as the other subjects in the degree program.
In our work the Ethics Committees, we sometimes find that there are gaps in the Code or the Bylaws. In medical ethics, too, the world is a small place: we can find elsewhere what we lack here. More frequently, as we move toward ever-greater European integration, both in the review of ethics cases and in research medical ethics and deontology, we must rely on the regulations in force in other countries or on international regulations of varying scope and origin. In teaching as well, teaching turn to external standards to try to fill the gaps in our own code of ethics, to compare our ethics with those in force in other countries, and to conduct a comparative analysis of our rules.
Among all this documentation, the Declarations and Principles promulgated by the World association since 1948 are of particular interest as primary ethical sources. And, alongside them and with even greater internship, the Nuremberg and Luxembourg Declarations of committee of Doctors of the European Community, which establish the instructions medical practice in the Europe of the Twelve. Although not legally binding, the valuable Principles of Medical Ethics for Europe—which the lecture of Medical Associations unanimously approved in January 1987—serve as reference letter the harmonization of professional ethics. There are also certain Directives from committee , as well as Guidelines or Recommendations from committee hoc Bioethics committee of committee Europe, which contain substantial ethical content. Finally, the Declarations of the Central Commission on Medical Ethics, once approved by the committee , hold particular significance for us.
These documents possess varying but undeniable authority. Some are exclusively moral in nature. Others are ethically binding. A few, such as those issued by the committee Europe, acquire legal force once ratified by the member states. Despite the contradictions that exist among some of these documents, together they constitute a collection of high-quality texts, into which a great deal of moral wisdom and extensive experience—born of the resolution of many ethical problems in the medical profession—has been distilled. Unfortunately, their content—and even their very existence—is ignored by a large number of physicians. This is a shame, because they could serve as a stimulating tonic during times of moral exhaustion or administrative harassment.
Many of them should be included, alongside the Hippocratic Oath and Maimonides’ Prayer, as appendices in the standard edition of the Code of Medical Ethics and Deontology, similar to what is done in the deluxe edition, which includes nearly all of the World association Declarations. Students in medical ethics courses should be familiar with them either directly or through frequent citations and references made when discussing our Code. They serve as a technical and moral reinforcement of our Code. They broaden the horizons of our ethics.
IV. The Responsibilities of Institutional Ethics
I would like to conclude by highlighting one point. It is a universal experience that the presence of a student in a conference room or outpatient clinic has a beneficial effect on the work . The simple fact of feeling observed by a student—who is certainly inexperienced but also a critical observer—compels the doctor to do things properly, to avoid being careless or negligent, and to account for their actions or omissions.
The teaching medical ethics does not merely present students with a utopian theory of moral dignity and the noble traditions of the medical profession. It also provides them with the tools to critically evaluate the conduct of their professors or the physicians with whom they come into contact. The presence of students and recent graduates who understand the demands of medical ethics will undoubtedly have a revitalizing, stimulating effect in hospital wards and outpatient clinics.
It will also have a stimulating effect on the field of medical ethics. Royal Decree 1417/1990 stipulates that universities must allocate between 60 and 70 percent of total credits to practical coursework. This entails presentation clinical ethics cases and, naturally, the study of medical ethics. Whether the ethics revived for the Education of new generations of doctors becomes an instrument for their ethical elevation or a means of turning them into cynics will depend on the sincerity and seriousness of the ethical oversight exercised by the professional associations. My experience is that the teaching of medical ethics to students provides ongoing training in sincerity and acts as a vaccine against the hardening of conscience.
It takes only a few sentences to summarize the conclusions discussion paper from this discussion paper , which, after further discussion and refinement, the congress submit to the committee for appropriate action.
1. Medical students must be provided with Education in medical ethics and professional conduct. This Education an essential and significant component of degree program .
2. A central component of this Education knowledge the Code of Medical Ethics and Professional Conduct and of the ethical and disciplinary standards set forth in the General Statutes of the Medical Association. This teaching must not omit reference letter the major documents and declarations that govern or inspire, at the international or European Union level, the relationships between the medical profession and society, between physicians and patients, or among physicians themselves.
3. The Medical Association must take an active role in engaging with the relevant authorities—including government agencies and universities—to ensure that, when the new Study program the graduate takes effect, professional ethics is included as a core component of medical teaching .
4. Members of the Ethics Committees of the Medical Associations are encouraged to make themselves available to collaborate closely and in a variety of ways with Schools in the teaching medical ethics, thereby contributing to the achievement of the goal in Conclusion 2.
Thank you very much.