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How do Medical Students Learn Ethics?

3 Aug, 15 | by Iain Brassington

Guest Post by Carolyn Johnston

How interested are medical students in learning ethics and law? I have met students who have a genuine interest in the issues, who are engaged in teaching sessions and may go on to intercalate in ethics and law. On the other hand some consider that ethics is “just common sense”. They want to know only the legal parameters within which they will go on to practice and do not want to be troubled with a discussion of ethical issues for which there may not be a “correct” answer.

Ethics and law is a core part of the undergraduate medical curriculum and so in order to engage students successfully I need to know whether my teaching materials are relevant, useful and interesting. In 2010 I ran a student selected component in which MBBS Year 2 students created materials for medical ethics and law topics for pre-clinical students which they considered were engaging and relevant, so that students might go further than learning merely to pass exams. One student, Marcus Sorensen, who had managed a design consultancy focusing on web design and development before starting his medical studies, came up with the idea of a website as a platform for ethics materials for King’s students and he created the website

It was through our ongoing discussions that we identified a lack of information about students’ experiences of learning medical ethics and law, especially outside the classroom environment. more…

Mitochondrial Disease and the HFEA

20 Sep, 12 | by Iain Brassington

Readers are probably aware of the consultation that the HFEA launched this week on the use of mitochondrial replacement to prevent certain illnesses.  John Harris has a piece on it in The Guardian – and by gosh golly, he’s right*; the article is well worth a quick look.

My own ha’p’orth: some of the stuff in the consultation is a bit odd.  One of the sets of questions it asks has to do with what such a procedure would do to a child’s concept of identity.  But why is this a concern?  Suppose a child discovers that she’s been the recipient of a mitochondrial transplant: so what?  Why would that make the blindest bit of difference to her sense of identity?  Isn’t it wholly plausible that, if there is any impact, it’s not because of the source of the genes qua genes, but because of all the people around her telling her that it’s tremendously important and she should give a stuff?  But they might be wrong.  I’d stick my neck out and say that they probably are.  Genetic origins simply don’t matter.

(Ah – but if she’s brought up to think that they’re imporant, isn’t that enough to establish that they’re important to her – and so are important in some sense after all?  Well, no.  Imagine someone is brought up to think that the fortunes of West Ham United are important; they’ll be important to him.  But it doesn’t follow that they’re important; and it might be that, in treating them as important, our hapless Hammers fan ends up making himself much more miserable than he need be by worrying about things that don’t merit worry.  It could be that he ought not to think the football important.  The same applies to genes: if a person’s genetic origins are important to her, it doesn’t follow that they’re important, or that there’re no good reasons to think them less important.)

But lots of people seem to think that genes do matter, and so we get questions like this; and asking questions like this perpetuates the idea that it’s a question worth asking… and so it goes on.

*I’ve found myself saying that increasingly often of late.  Scary stuff.

Organs and Payment: cui bono?

20 Oct, 11 | by Iain Brassington

Dipping in and out of the Nuffield Council on Bioethics’ recent report on organ donation (available in various forms from this page), I’ve been struck by a couple of things.

One is that the Council is painfully keen to maintain its distance from the idea that organs – especially those from live donors – could be sold.  The report makes clear that not every form of payment for donation implies this kind of commodification, and is correct to do so.  But, all the same, it’s pretty clear in its insistence that sale would be a Bad Thing.  And, of course, this just invites fairly conventional arguments about whether, and why, sale of organs really would be so bad after all.  One of the worries nodded towards here is the commodification objection – but it seems plain to me that it’s one thing for you to treat me or my body as a mere commodity, but quite another for me to treat my own body as such.  And there’s also a difference – at least on the face of it – between being treated as a commodity and being treated merely as a commodity.

(On this note, I cringed at the way that Kant is mangled on p 120 of the full report.  But that’s possibly just me and my soft spot for the Prussian weirdo.)

So far, so conventional.  What really caught my attention – partly because it caught the attention of headline-writers in the news media – was the proposal that payment might be offered to defray the funeral costs of people whose organs could be used. more…

Consultation: Emerging Biotechnologies

6 Apr, 11 | by Iain Brassington

The Nuffield Council on Bioethics has announced that it has opened a consultation on emerging biotechnologies:

The Council is seeking views on the ethical issues posed by emerging biotechnologies. Your views will be valuable in shaping and informing the deliberations of a Working Party that was recently set up to consider this topic.

The Working Party is interested in the way society and policy makers respond to new biotechnologies and how benefits from these technologies can be secured in an ethically appropriate manner. This issue will be considered in light of both current examples of emerging biotechnologies, such as synthetic biology and nanotechnology, and older cases, such as genetically modified crops and assisted reproduction technologies.

All responses will be considered carefully by the Working Party. We aim to publish our final report, including recommendations to policy makers, in autumn 2012.

The consultation document and response form are available to download here.

Consent and Consensus

15 May, 10 | by Iain Brassington

For the past week, the news in the UK has been all about coalitions, compromise, consensus and that sort of thing.  The hung Parliament has been heralded as ushering in a new era of politics-by-agreement, rather than by the traditional Westminster model of simply flattening everyone else.  And a lot of people seem to think that such a change in tone is a good thing.

But it’s not just in politics that consensus has its supporters.  You occasionally see it popping up in medical contexts – specifically, when it comes to questions of consent.


When the Witch Asks a Question, I Can’t Resist

4 Nov, 09 | by Iain Brassington

In the replies to this thread, The Witch Doctor asks this:

A Scenario:

Apparently there are some sites on the web just now claiming that the world is going to end in 2012. Some teenagers are becoming agitated.

I don’t want to be around when the world ends, so I’m going to drink some poison and present to my local A and E department on Halloween 2011. If conscious I will refuse treatment but ask to be kept pain free and as comfortable as possible while I make a “dignified exit” anticipating the end of the world.

I will also carry an AD in case I become unconscious before arriving at A and E.

If conscious, I will be assumed to be competent until proven otherwise. I will pass the competency test. I do not have a mental health problem. I have just been spending too much time surfing the web.

Should the medical staff allow me to die when the time comes and if not, why not?

It’s a good question – though I’d rephrase it slightly to “if so, why; and if not, why not?” at the end.

I’m curious to know what the readership here thinks.  Since I’ve posted my reply in the old thread, I’ll keep out of it as much as possible.

What should UK medical students learn about ethics? Your chance to have your say

3 Jul, 09 | by Søren Holm

The Institute of Medical Ethics is currently revising the Core Curriculum in Medical Ethics and Law. This is arguably the only document laying out in any kind of detail what medical students in the UK should learn about ethics in medical school, and is therefore not unimportant!

A consultation on the revision in now open (until 31.07.09) and the draft Core Curriculum and consultation document can be found at:

So, provide your comments now to the IME or forever be silent (or at least be silent until the next revision).

consultation on medical profiling and online medicine: the ethics of ‘personalised’ health care in a consumer age

24 Apr, 09 | by David Hunter

I thought this call for input would be of interest to some of our readers.

The Nuffield Council on Bioethics is holding a public consultation on the ethical issues raised by online healthcare, telemedicine and commercial medical profiling technologies such as DNA testing and body imaging. These technologies and services are increasingly focused on the individual, and often mean that the GP is no longer involved in healthcare.


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