The teaching of ethics in UK medical schools has recently been reviewed, from the perspective of the teachers themselves. A questionnaire survey of medical undergraduates at King’s College London School of Medicine provides useful insight into the students’ perception of ethics education, what they consider to be the value of learning ethics and law, and how engaged they feel with the subject.
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↵i “graduates must know about and understand the main ethical and legal issues they will come across” (General Medical Council,2 para 29).
↵ii Conference held at BMA House, London, 29 March 2006, convened by the British Medical Association’s Medical Ethics Department and cohosted with The Higher Education Academy and the Institute of Medical Ethics.
↵iii The medical schools of Guy’s and St Thomas’s merged with the School of Medicine, King’s College London, in August 1998.
↵iv King’s College also runs the Graduate Entry Programme and Extended Medical Degree Programme.
↵v One full time and the other part time.
↵vi Students in year 3 were not included, as there was no dedicated contact time with this group within the time parameters of the review. Some students intercalating in Clinical Health Care Ethics and Law gave valuable input in the drafting of the questionnaire.
↵vii The same student considered that the reason for having an understanding of ethical and legal issues was to “prevent me from being sued”. We wonder whether a lack of awareness of ethical issues might be taken into account when assessing the clinical competence of students (The Pond Report,1 p 22). “A (third) type of unethical doctor may be one who does not care about the ethical side of his practice” (Lowe et al,4 p 404).
↵viii “Among the reasons why [problems raised by the practice of medicine] are problems, is that normally they cannot be resolved simply by appealing to professional codes, or to science, religion, the law or even common sense” (Institute of Medical Ethics,1 p 2).
↵ix Lowe et al consider that there is “a paucity of evidence that undergraduate or postgraduate education may change or shape ethical practice in the long term” (Lowe et al,4 p 404). Evidence of a significant gain in the adoption of principled reasoning after a course in medical ethics.6
↵x Of the students responding in year 5, 18 students said “yes”—the teaching had helped their ability to resolve difficult issues; only 1 said “no”. By comparison, 47 students in year 4 agreed that the teaching had helped their ability to resolve difficult issues, 11 said that it had not.
↵xi “The initial aims of ethics teaching are to help students develop both an awareness of where and what ethical problems are, and an intellectual framework within which these problems can be examined” (Institute of Medical Ethics,1 p 12).
↵xii “The majority of schools used a combination of large and small group teaching” (Mattick and Bligh,8 p 183).
↵xiii Twenty-five students ticked more than one box, and these responses have not been included in this analysis.
↵xiv Nearly half (47%) of clinical students, one year from completing medical school, reported that they had felt pressure to act unethically in a clinical situation (Hicks et al,9 p 709).
Competing interests: None.
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