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Combating junior doctors’ “4am logic”: a challenge for medical ethics education
  1. R McDougall
  1. Ms R McDougall, Centre for Health and Society, Level 4, 207 Bouverie St, University of Melbourne VIC 3010, Australia; rmcdo{at}


Undergraduate medical ethics education currently focuses on ethical concepts and reasoning. This paper uses an intern’s story of an ethically challenging situation to argue that this emphasis is problematic in terms of ensuring students’ ethical practice as junior doctors. The story suggests that it is aligning their actions with the values that they reflectively embrace that can present difficulties for junior doctors working in the pressures of the hospital environment, rather than reasoning to an ethically appropriate action. I argue that junior doctors need skills for implementing their ethical decisions and that these ought to form a central component of undergraduate medical ethics education.

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  • Funding: This work was funded by an Australian Postgraduate Award.

  • Competing interests: None.

  • Ethics approval: The study was approved by the Human Research Ethics Committee of the hospital involved and was also registered with the University of Melbourne Human Research Ethics Committee.

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