RT Journal Article SR Electronic T1 Medical learning curves and the Kantian ideal JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 513 OP 518 DO 10.1136/jme.2004.009316 VO 31 IS 9 A1 P Le Morvan A1 B Stock YR 2005 UL http://jme.bmj.com/content/31/9/513.abstract AB A hitherto unexamined problem for the “Kantian ideal” that one should always treat patients as ends in themselves, and never only as a means to other ends, is explored in this paper. The problem consists of a prima facie conflict between this Kantian ideal and the reality of medical practice. This conflict arises because, at least presently, medical practitioners can only acquire certain skills and abilities by practising on live, human patients, and given the inevitability and ubiquity of learning curves, this learning requires some patients to be treated only as a means to this end. A number of ways of attempting to establish the compatibility of the Kantian Ideal with the reality of medical practice are considered. Each attempt is found to be unsuccessful. Accordingly, until a way is found to reconcile them, we conclude that the Kantian ideal is inconsistent with the reality of medical practice.