Introduction: The teacher-student relationship in medicine determines the bond established with the patient. Objective: This study was designed to compare if first and third year medical students at a university perceived incidents perpetrated by teachers as morally wrong. Materials and methods: A semi-structured survey was used with open and closed items; specifically, participants were asked to relate a morally wrong incident, classified to six categories. Results: 80.7% in the third-year students and 30.4% of the first-year students (...) perceived incidents that involved mostly auxiliary personnel and evaluations. Verbal abuse and unfair assessment were the categories mentioned the most. Discussion: A morally wrong incident is a general concept, differing from other studies that specifically analyze abuse, also evident in this concept. Conclusion: A lack of respect and justice could indicate a lack of moral commitment. (shrink)

In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken (...) to train medical students, interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development. (shrink)

As the practice of medicine inevitably raises both ethical and legal issues, it had been recommended since 1999 that medical ethics and human rights be taught at every medical school. Most Nigerian medical schools still lack a formal undergraduate medical ethics curriculum. Medical education remains largely focused on traditional medical science components, leaving the medical students to develop medical ethical decision-making skills and moral attitudes passively within institutions noted for relatively strong paternalistic (...) traditions. In conducting a needs assessment for developing a curriculum germane to the Nigerian society, and by extension most of Sub-Saharan Africa, this study determined the views of Nigerian medical students on medical ethics education, ethical issues related to the doctor-patient relationship and the ethical/professional dilemmas they are confronted with. Using self-administered 63-item structured questionnaires, a cross-sectional survey of the final year medical students of the University of Nigeria was conducted in July 2015.Using the Statistical Package for the Social Sciences software (SPSS Version 17), frequency counts and percentages were generated. The sample included 100 males (71.4%) and 40 females (28.6%), with the respective mean (SD) age being 24.6(5.61) and 21.8 (6.38) years. Only 35.7% were satisfied with their medical ethics knowledge, and 97.9% indicated that medical ethics should be taught formally. Only 8.6% had never witnessed a medical teacher act unethically. The dilemmas of poor communication between physicians and patients, and the provision of sub-standard care were reported highest for being encountered ‘often’. A majority (60.7%) indicated that “a doctor should do his best always, irrespective of the patient’s wishes”. No significant difference in responses across gender was noted. There is a strong desire by the contemporary Nigerian medical student for medical ethics education. Their lack of exposure in medical ethics in an ethically challenging environment suggest a dire need for the development of an appropriate medical ethics curriculum for them and the provision of an ethically conducive learning environment. (shrink)

Objective: The purpose of this study was to demonstrate how educators involved in the teaching of bioethics to healthcare university students in Japan would cope with ethical disagreement in the classroom, and to identify factors influencing them.Methods: A cross sectional survey was conducted using self administered questionnaires mailed to a sample of university faculty in charge of bioethics curriculum for university healthcare students.Results: A total of 107 usable questionnaires were returned: a response rate of 61.5%. When facing ethical disagreement in (...) the classroom, coping behaviour differed depending on the topic of discussion, was influenced by educators’ individual clear ethical attitudes regarding the topic of discussion, and was independent of many respondents’ individual and social backgrounds. Among educators, it was commonly recognised that the purpose of bioethics education was to raise the level of awareness of ethical problems, to provide information about and knowledge of those issues, to raise students’ sensitivity to ethical problems, and to teach students methods of reasoning and logical argument. Yet, despite this, several respondents considered the purpose of bioethics education to be to influence students about normative ethical judgments. There was no clear relationship, however, between ways of coping with ethical disagreement and educators’ sense of the purpose of bioethics education.Conclusions: This descriptive study suggests that educators involved in bioethics education for healthcare university students in Japan coped in various ways with ethical disagreement. Further research concerning ethical disagreement in educational settings is needed to provide better bioethics education for healthcare students. (shrink)

This book explores Aristotelian and Confucian wisdom traditions to understand education and what counts as a good teacher in an embodied dialogic approach. The book creates a dialogue between ancient ideas and the author's lived experiences as a teacher in cross-cultural landscapes today to ruminate on the important themes of educational purpose, teacher excellence, teacher-student relationships, and teaching skill. It asks fundamental educational questions including "Why Do We Educate? Eudaimonia and Dao"; "What Do We Educate? (...) Phronesis, Philia and Ren"; and "How Do We Educate? Techne and Liuyi". Moving beyond the dominant epistemological concerns such as how to teach more effectively to help students gain better marks in schools, it constitutes an ethical inquiry that illuminates the values, purposes, concerns, and hopes that animate genuinely educational work. Using a comparative approach to wisdom traditions from both the East and the West, it addresses parochialism and challenges Eurocentric research paradigms. Embedded in the messy ground of teaching in intergenerational and cross-cultural narratives, the author's own experiences as a student/teacher/daughter of a teacher/mother of a student crucially unpacks and concretizes ancient concepts and reactivates them in concrete situations. A sense of a whole without completeness, a conception of the good without closure, and an aspiration without achievement continue to haunt the search for an ultimate answer to the question "what counts as a good teacher?". It will appeal to scholars, teachers, and teacher educators with an interest in narrative inquiry and educational research, as well as those in the field of curriculum studies and the philosophy of education. (shrink)

Background: Ethics stimulation in nursing education focuses on human, non-technical factors in a clinical reality. Simulation as a teaching method began in the 1930s with flight simulators. In the beginning of the 1990s, simulations developed further in tandem with other technological and digital inventions, including touchscreen and three-dimensional anatomical models. Medical science first used simulation as a pedagogical teaching tool. In nursing education, simulation has been used for approximately a hundred years. Teaching has mainly focused on medical-technical, patient-specific (...) interventions and their management. Objective: The objective of this study was, from a caring science didactic perspective, to deepen the understanding of ethics simulation in nursing education. Design: Qualitative design and explorative, descriptive and hermeneutic approach of an inductive character. Methods: Semi-structured face-to-face interviews in 2016–2017 with six Norwegian nursing students who were encouraged to narrate about their experiences of ethics simulation in nursing education. Ethical considerations: Informed consent was obtained from the participants. Anonymity and confidentiality regarding data material were guaranteed. Results: Interpretation of the nursing students’ narratives resulted in the following meaning units: ethical being and ethos, nursing students’ formation process, bridge-building between theory and clinical practice, and teacher and ethics simulation. Conclusion: Through ethics simulation, nursing students can obtain an increased knowledge and a sense of being able to handle difficult ethical situations. Nursing students’ values, moral actions and ethical value base offer a positive point of departure, for both theoretical and practical ethics teaching, and an awareness of the unique human being, the patient, in clinical reality. The implementation of ethics simulation needs more attention in nursing education. (shrink)

This book focuses on moral and political education and critically engages with educational issues from a philosophical perspective. It engages with questions of moral education as well as questions about citizenship education, to address apprehensions on learning in a liberal democracy while parallelly invoking issues from within the curriculum, the school environment and teacher-student relationship. With contributions from renowned philosophers and educationists, this volume discusses themes like civic education and liberal democracy; toleration and freedom; Tagore's conception of (...) the moral and political self; key issues in moral education; cosmopolitanism, compassion, care ethics and moral purpose of schooling; to revisit and rethink some foundational questions related to education, curriculum and pedagogy. This volume will be essential reading for educationists and educators, and will be important for scholars and researchers of philosophy of education, education, teacher education and school education. (shrink)

The importance of Morality Education is globally recognized. Effectiveness of such programs necessitates that due consideration be given to sociocultural factors, which consist of enablers and potential barriers. Several research work have been conducted in this specific domain, highlighting its importance in numerous aspects of adolescents’ lives. This calls to the need to integrate ME in lives of school-aged adolescents from a multicultural background and socioeconomically deprived regions. This small-scale intervention’s aim was to investigate the perspectives concerning ME, taking into (...) close consideration the sociocultural factors, constituting of enablers and potential barriers. The study makes use of a qualitative approach to research conducted in Mauritius, a developing country with a significantly multicultural population and where ME is rarely and properly addressed to students, despite changes in behaviors and mindset of the country’s adolescents. The sample was selected through purposive sampling and the study consisted of semi-structured interviews conducted, with study participants, comprising of teachers, students and parents. Students came from diverse backgrounds and socioeconomically deprived areas. The interview transcripts revealed that enabling factors were perceived as the role of external factors, integrating family members, meeting special needs, societal contribution, personal development, enrichment of knowledge and values and responsibility and consciousness. The potential barriers were perceived as resistance from teachers and students and technological advances. Generation gap was found as both an enabling factor and a potential barrier. The findings have implications for the design and implementation of school-based ME within a multicultural context, paving the way for related larger scales studies. (shrink)

Patients’ perception with regards to their use in medical teaching is an under-researched area in Pakistan. The objective of this qualitative, pilot study was to determine the perspectives of hospital admitted patients on their being used in the medical education of students in a private medical institution. An attempt to understand the dynamics of interactions between patients, students and doctors was also made and to see how this affected the doctor-patient relationship. A qualitative study with in-depth (...) interviews was conducted in a private medical college of Islamabad, Pakistan with a total of 20 adult patients. The focus was on their experiences with bedside teaching. This pilot study reveals interesting findings about patient-physician interactions in Pakistan. Patients had a traditionally passive role in medical education putting more onuses on the doctor to impart knowledge to the medical students. Patients comforted themselves in the knowledge that they were following Allah’s command when they were involved in the teaching of medical students. The apparent altruism of Pakistani patients in this study was influenced mainly by religious reasons, following the commandments of Allah to help develop future healers for humanity. The culture evident in the medical college where this study was conducted is reflective of the social power ladders that pervade Pakistani society. The positions of doctors and medical teachers in Pakistani society are hardly challenged to debate. Little attention has been paid to the values that influence the cultural and social frameworks within which Pakistani medical teachers, medical students and the patients function. (shrink)

Nurses frequently encounter situations in which they are compelled to make ethical decisions about what is good and right to do in their day-to-day practice. Often existing moral edicts prove to be inadequate in light of the patient's particular circumstances. To what, then, can the nurse turn? In response to this question, Gadow (1999) proposes a dialectical framework comprised of three ethical approaches: subjective immersion (ethical immediacy), objective detachment (ethical universalism), and intersubjective engagement (relational narrative). In this paper, the dialectic (...) framework proposed by Gadow (1999) is examined with respect to some of its potential implications for nursing practice and education. This endeavour is undertaken in the spirit of extending the dialogue that Gadow has so eloquently initiated. Questions related to whether it is possible (or necessary) to reconcile the contradictory tenets of these ethical approaches or the potential disjunction between the knowledge embedded in the relational narrative and ensuing action on the part of the nurse are discussed. In addition, some of the potential implications of this dialectical framework for nurse education are explored, including the question of how nurses learn to enter into a relational narrative with another and the relevance of relational narratives to teacher–student relationships. (shrink)

The article is dedicated to the exploration of the philosophy of trust by the Danish thinker and theologian Knud Ejler Løgstrup (1905–1981) as a founda­tion for moral education in the educational environment. The author emphasizes key concepts proposed by K. E. Løgstrup, such as the “ethical demand” and trust, which are considered not only as interpersonal phenomena but also as funda­mental components of moral formation. Particular attention is given to the role of trust in the teacher-student relationship, (...) which contributes to the development of moral consciousness, empathy, and responsibility. The article's author emphasizes the relevance of the ideas of the Danish philosopher, who remains relatively unknown to Ukrainian readers, as well as their significance for contem­porary Ukrainian pedagogy, particularly in the context of shaping a humanistic educational space where trust serves as a prerequisite for ethical education. The article also highlights the practical application of K. E. Løgstrup’s philosophical ideas in the educational process, specifically in fostering interdependence and moral responsibility among participants in the educational process. In this con­text, the philosophy of trust takes a central place, stressing the unconditional na­ture of the “ethical demand” and the necessity of assuming responsibility for the Other. The philosophy of trust in education plays a vital role in the development of life skills such as critical thinking, social interaction, and moral maturity. It fos­ters the creation of conditions for the conscious formation of individuals capable of navigating contemporary challenges and contributing to the construction of a just and sustainable society. Thus, the phenomenon of trust is not only a theoreti­cal concept but also a practical tool for enhancing a unique educational existence in the modern world. Trust is a social reality that cannot be reduced merely to a phenomenon, as it emerges from human relationships and intertwines with our actions and daily lives. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might (...) be causing them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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It is time for the noon conference. Your job is to impart a career-changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1½ h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this “tragic case” approach to ethics education is of limited value because it limits understanding (...) of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider-patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties. (shrink)

Ethical views of the first-year to sixth-year medical students were studied during bioethics education via questionnaire in 2004. Questions included “would you treat a mentally ill man condemned to death to fit him for execution?”, “is a criminal law suit against a surgeon responsible for a patient's death reasonable?” and “should a surgeon responsible for a patient's death be prosecuted for manslaughter.” The number of students answered “yes, to treat a mentally ill man” tended to increase as they moved (...) up to the senior classes, although there was no statistical significance. A criminal law suit against the surgeon and the charge of manslaughter was responded with a wide variety among the classes, that is the second-year and fifth-year students showed less favorable attitudes to the law suit against the surgeon than the first-year, third-year and fourth-year students. There was no distinct relationship with age, gender or the past bioethics education. Thus, the attitudes of medical students agree on one, and differ on other ethical issues depending on their classes. Although the reason for the difference in ethical views among classes was not clear, these results suggested that ethics education was a sensitive subject for medical students hence the manner of ethics education by teachers was of critical importance. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.1 (2001) 91-112 [Access article in PDF] Scope Note 40 Animals in Research and Education: Ethical Issues Laura Jane Bishop and Anita Lonnes Nolen Scientific enquiry is inexorably tied to animal experimentation in the popular imagination and human history. Many, if not most, of the spectacular innovations in the medical understanding and treatment of today's human maladies have been based on research using (...) animals. However, the use of animals in research and experimentation has been debated, defended, and protested by both individuals and organizations at various levels. Responses range from personal lifestyle decisions and fervent philosophical treatises to strident arguments, violent demonstrations, and direct action. The continuum of attitudes about animals and the human relationship with animals spans the range between those who support no regulation of the human use of animals and those who advocate absolute animal liberation from all human use (see II, Orlans 1993, p. 22). History The first recorded experimentation on animals occurred in ancient Rome, but not until the Renaissance did scholars begin serious study of how the body works. Leonardo da Vinci (1452-1519) and other artists and anatomists pursued anatomical investigations of muscle and bone structure. William Harvey (1578-1657) discovered the circulation of the blood via his experiments on live deer. During this period, much live animal experimentation both in England and France was based on the view of French philosopher René Descartes (1596-1650) that animals are incapable of feeling pain. Jeremy Bentham (1748-1832), the English utilitarian philosopher, thought otherwise. In his "Introduction to the Principles of Morals and Legislation" in 1789, Bentham declared, "The question is not, can they reason? Nor, can they talk? But can they suffer? Despite Bentham and others, the belief that animals could not perceive pain persisted in many quarters into the twentieth century. Nineteenth century French physiologist Claude Bernard [End Page 91] (1813-1878)-and his teacher, François Magendie (1783-1855)-conducted wide-ranging animal experiments including surgery, use of drugs, and removal of body parts from many species. Bernard argued that while no amount of benefit could justify any harm to human research subjects, even extreme harm and pain for animal research subjects could be justified by the potential benefit to human beings. Although he did use anesthetics in his work after their discovery in 1847, even Bernard's later work was controversial because of the numbers of animals used and the repetitive nature of his research. The experiments of Magendie and Bernard both laid the foundations for animal experimentation as a practice for scientific advance and contributed in large measure to the emergence of the anti-vivisection movement. Public protests over animal experiments conducted in France and the fear that these might come to England led to the passage of the first law controlling animal experimentation, the "1876 Cruelty to Animals Act" in England. This history and the dynamic tension between scientific inquiry and public concern set the stage for the activism and scholarship of the twentieth century.Since the 1960s, the amount of attention, activism, and scholarship related to animal use has increased at a rapid pace. The modern animal protection movement, led by the Australian philosopher Peter Singer in his book, Animal Liberation (II, 1975), based its advocacy on animals' ability to experience pain and suffering (Bentham's argument). Singer's book and other investigations into animal research, such as LIFE magazine's photojournalism piece on pet theft, animal cruelty, and animal experimentation (Concentration Camps for Dogs. LIFE (4 February 1966), pp. 22-29), brought the use of animals in research, testing, and education to the attention of the general public. Activists, advocates, laypersons, scientists, lawmakers, and animals themselves, have created the interesting, complicated, and complex history of animal rights and animal welfare over the last several decades. Current Statistics Worldwide, approximately 35 million animals are used in research each year; the United States alone uses 12 million animals annually--more than any other country. In 1998, the official number of research animals recorded in the United States was 1... (shrink)

Ethics teachers are regularly confronted with disturbing cases brought in by medical students in class. These classes are considered confidential, so that everyone can speak freely about their experiences. But what should ethics teachers do when they hear about a situation they consider to be outright alarming, for example where patients/students’ safety is at stake or where systematic power abuse seems to be at hand? Should they remain neutral or should they step in and intervene? In the Netherlands, as (...) in many other countries, there are no clear guidelines for ethics teachers on how to respond. To get more insight into what teachers themselves think a proper response would be, we interviewed 18 Dutch medical ethics teachers. We found that Dutch ethics teachers will address the issue in class, but that they are overall reluctant to intervene; take action outside the scope of class. This reluctance is partly rooted in the conviction that ethicists should stay neutral and facilitate reflection, instead of telling students or physicians what to do. At the same time, this neutral position seems a difficult place to leave for those teachers who would want to or feel they need to. This has to do with various organizational and institutional constraints tied up with their position. The study invites medical ethics teachers to reflect on these constraints together and think about how to proceed from there. This study seeks to contribute to research on cultural change in medicine and medical students’ experiences of moral distress. (shrink)

In this paper I argue that medical education must remain attuned to the interests that physicians have in their own self-development despite ongoing calls for ethics education aimed at ensuring physicians maintain focus on the interests of the patient and society. In particular, I argue that medical education should advance criteria defining what counts as an educationally worthwhile activity from the perspective of the medical student understood as a learner. I offer a preliminary account and justification (...) of such criteria, arguing that such criteria warrant a process of ethical formation that better serves the interests of medical students, their patients and society. (shrink)

Background: Community-based education (CBE) involves educating the head (cognitive), heart (affective), and the hand (practical) by utilizing tools that enable us to broaden and interrogate our value systems. This article reports on the use of virtue ethics (VE) theory for understanding the principles that create, maintain and sustain a socially accountable community placement programme for undergraduate medical students. Our research questions driving this secondary analysis were; what are the goods which are internal to the successful practice of CBE in (...) medicine, and what are the virtues that are likely to promote and sustain them? -/- Methods: We conducted a secondary theoretically informed thematic analysis of the primary data based on MacIntyre’s virtue ethics theory as the conceptual framework. -/- Results: Virtue ethics is an ethical approach that emphasizes the role of character and virtue in shaping moral behavior; when individuals engage in practices (such as CBE), goods internal to those practices (such as a collaborative attitude) strengthen the practices themselves, but also augment those individuals’ virtues, and that of their community (such as empathy). We identified several goods that are internal to the practice of CBE and accompanying virtues as important for the development, implementation and sustainability of a socially accountable community placement programme. A service-oriented mind-set, a deep understanding of community needs, a transformed mind, and a collaborative approach emerged as goods internal to the practice of a socially accountable CBE. The virtues needed to sustain the identified internal goods included empathy and compassion, connectedness, accountability, engagement [sustained relationship], cooperation, perseverance, and willingness to be an agent of change. -/- Conclusion: This study found that MacIntyre’s virtue ethics theory provided a useful theoretical lens for understanding the principles that create, maintain and sustain CBE practice. (shrink)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and (...) conflict were higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

"New foreword by Rhian Evans Allvin"--Cover.

Many academic philosophers and ethicists are appointed to teach ethics to medical students. We explore exactly what this task entails. In South Africa the Health Professions Council's curriculum for training medical practitioners requires not only that students be taught to apply ethical theory to issues and be made aware of the legal and regulatory requirements of their profession, it also expects moral formation and the inculcation of professional virtue in students. We explore whether such expectations are reasonable. We (...) defend the claim that physicians ought to be persons of virtuous character, on the grounds of the social contract between society and the profession. We further argue that since the expectations of virtue of health care professionals are reasonable, it is also sound reasoning to expect ethics teachers to try to inculcate such virtues in their students, so far as this is possible. Furthermore, this requires of such teachers that they be suitable role models of ethical practice and virtue, themselves. We claim that this applies to ethics teachers who are themselves not members of the medical profession, too, even though they are not bound by the same social contract as doctors. We conclude that those who accept employment as teachers of ethics to medical students, where as part of their contractual obligation they are expected to inculcate moral values in their students, ought to be prepared to accept their responsibility to be professionally ethical, themselves. (shrink)

Respect is a cardinal virtue in schools and foundational to our common ethical beliefs, yet its meaning is muddled. For philosophers Kant, Mill, and Rawls, whose influential theories span three centuries, respect includes appreciation of universal human dignity, equality, and autonomy. In their view children, possessors of human dignity, but without perspective and reasoning ability, are entitled only to the most minimal respect. While undeserving of mutual respect they are nonetheless expected to show unilateral respect. Dewey and Piaget, scions of (...) the same liberal tradition, grant children a larger degree of autonomy and equality thereby approximating the full respect conditions reserved for adults in the prior theories. In this article, after reviewing the premises of respect, I attempt to blend the divide - between minimal and full respect - by separating respect-due from respect-earned . While the former, premised on human dignity, should be granted unconditionally to all, the latter is contingent upon qualities that one possesses or acquires over time. Adding the notion of respect-due is a constraint on the prevalent school practice of turning respect into demands for deference. The relevance of this distinction is discussed in terms of student-teacher relationships. (shrink)

Recent findings suggest that medical students’ moral competence decreases throughout medical school. This pilot study gives preliminary insights into the effects of two educational interventions in ethics classes on moral competence among medical students in Munich, Germany. Between 2012 and 2013, medical students were tested using Lind’s Moral Competence Test prior to and after completing different ethics classes. The experimental group participated in principle-based structured case discussions and was compared with a control group with theory-based case (...) discussions. The pre/post C-scores were compared using a Wilcoxon Test, ANOVA and effect-size calculation. The C-score improved by around 3.2 C-points in the EG, and by 0.2 C-points in the CG. The mean C-score difference was not statistically significant for the EG or between the two groups. There was no statistical significance for the teachers’ influence on C-score. In both groups, students with below-average C-scores improved and students with above-average C-scores regressed. The increase of the C-Index was greater in the EG than in the CG. The absolute effect-size of the EG compared with the CG was 3.0 C-points, indicating a relevant effect. Teaching ethics with PBSCDs did not provide a statistically significant influence on students’ moral competence, compared with TBCDs. Yet, the effect size suggests that PBSCDs may improve moral competence among medical students more effectively. Further research with larger and completely randomized samples is needed to gain definite explanations for the results. (shrink)

_Re-Imagining Relationships in Education_ re-imagines relationships in contemporary education by bringing state-of-the-art theoretical and philosophical insights to bear on current teaching practices. Introduces theories based on various philosophical approaches into the realm of student teacher relationships Opens up innovative ways to think about teaching and new kinds of questions that can be raised Features a broad range of philosophical approaches that include Arendt, Beckett, Irigaray and Wollstonecraft to name but a few Includes contributors from Norway, England, Ireland, Scotland, (...) Spain, Sweden, and the U.S. (shrink)

Re-Imagining Relationships in Education re-imagines relationships in contemporary education by bringing state-of-the-art theoretical and philosophical insights to bear on current teaching practices. Introduces theories based on various philosophical approaches into the realm of student teacher relationships Opens up innovative ways to think about teaching and new kinds of questions that can be raised Features a broad range of philosophical approaches that include Arendt, Beckett, Irigaray and Wollstonecraft to name but a few Includes contributors from Norway, England, Ireland, Scotland, (...) Spain, Sweden, and the U.S. (shrink)

The article discusses the long-term experience of humanitarian education and the formation of moral values of the medical profession at the Volgograd State Medical University. It is considered the activities of the University for development of professional and scientific research competencies of students in the interdisciplinary field of medical and social sciences. The material of scientific research conducted by students shows the process of internalization by them of humanistic models of healing, experience of empathy and compassion, internalization (...) of bioethics and medical law. The article substantiates the conclusion that the practice of educational and scientific work in the field of bioethics, the productive collaboration of teachers of humanitarian and medical disciplines, successful publishing, active participation in all international scientific and educational events in the field of biomedical ethics and healthcare law, allows us to recommend the experience of Volgograd State Medical University as a model for the formation of the social and humanitarian space of medical education for a university s of the Ministry of Health of Russia. (shrink)

Unethical practices in education come at too great a cost when our future generation is at stake. Educators are role models for students in their future careers and so must believe in and use ethical practices. In politics, in big and small business, and in legal and medical practice the question of ethical practices surrounds us. Have people become desensitized to ethics? Are we condoning unethical practice? Our educational profession must stand up for honesty and integrity. We, as educators, (...) have the obligation of setting the standards for ethics. Ethical Dilemmas in Education addresses the dilemmas teachers face every day throughout all aspects of education in a comprehensive manner. The book outlines standards of professionalism and presents information teachers can use for the challenges teachers face. With the policies of today's educational system, teachers need to stand up for honesty and integrity, providing role models for students in their future careers. This book guides teachers towards developing ethical habits and a professional demeanor. (shrink)

How should ethical standards be maintained within engineering and engineering education? The present paper addresses this question with relation to the dominant models of engineering ethics (EE) to show that their limits might be overcome by incorporating the vocabulary of neo-Aristotelian virtue ethics. On the basis of the MacIntyrean concept of practice, the secondary role of engineering is highlighted which echoes similar debates concerning education. This similarity is picked up to argue that the role of the engineer in relation to (...) the end-users of their projects should be understood as on a par with the teacher-student relationship. This enables us not only to redefine the internal good of engineering and the ground for EE, but also to indicate the key virtues and educational models for engineering that they should be key parts of. (shrink)

The purpose of this study was to examine the norm conformity and value perceptions of Malaysian secondary school students. To measure adherence to value‐based social norms, a values/behaviour questionnaire was administered to approximately 400 Malaysian adolescents. The results showed a self‐reported high degree of conformity to social norms. In order to increase understanding of the moral dimensions of schooling, semi‐structured interviews were conducted with teachers and students which gave ‘voice’ to teachers and students as moral agents. The results indicate that (...) some students view school rules as too rigid and undermining the moral development schooling is trying to promote. The research also shows that the implicit values of respect, justice and fairness are central in Malaysian students' relationships with their teachers. This research shows teachers and students as active constructors of moral meaning and recommends that policymakers, when thinking about moral education reform, consider these views. (shrink)

Re-Imagining Relationships in Education re-imagines relationships in contemporary education by bringing state-of-the-art theoretical and philosophical insights to bear on current teaching practices. Introduces theories based on various philosophical approaches into the realm of student teacher relationships Opens up innovative ways to think about teaching and new kinds of questions that can be raised Features a broad range of philosophical approaches that include Arendt, Beckett, Irigaray and Wollstonecraft to name but a few Includes contributors from Norway, England, Ireland, Scotland, (...) Spain, Sweden, and the U.S. (shrink)

The authors’ aim is to bring to the attention of readers the inadequacies of care for people in Hungary who are terminally ill. They believe that both objective and subjective factors cause these inadequacies. Most of these factors arise from moral dilemmas that could be eased or even solved if ethics education had a much more prominent place in the nursing curriculum. Even if nurses would not become automatically better persons morally, a much wider knowledge of medical/nursing ethics could (...) significantly improve nursing care both before and at the end of life. Although the article is also critical of the nursing care provided, it is not its purpose to make any generalizations. The study utilized selected passages from essays written by 76 practicing nurses on their personal experience of ethical dilemmas in their work environment, and a questionnaire administered to 250 students (registered nurses and health care students) studying for a college degree. This article is written by two authors who have formed an unusal alliance: a registered nurse with 29 years’ experience of bedside nursing, but who is currently a teacher of nursing ethics at a local health college, and a lawyer turned bioethicist. (shrink)

Background: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process. Objectives: This study aimed to explore and to evaluate the nursing students’ ethical challenges in the clinical settings in Iran. Research design: This was a mixed-methods study with an exploratory sequential design. Participants and research context: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively. Ethical considerations: The ethical committee (...) of Kerman University of Medical Sciences, Iran, approved the protocol of the study. Findings: Three main categories were extracted from qualitative data including Low attention of nurses to the patients’ preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the “Low attention of nurses to the patients’ preferences” subscale. Discussion: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students’ ethical challenges. Conclusion: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students’ ethical challenges and their impact on nursing students’ clinical experiences. (shrink)

Background: Nurses and student nurses in Malawi often encounter challenges in taking a moral course of action. Several studies have demonstrated a need for increased awareness of ethical issues in the nursing education. Objective: To explore the challenges experienced by nurse teachers in Malawi in their efforts to enhance students’ moral competence in clinical practice. Research design: A qualitative hermeneutic approach was employed to interpret the teachers’ experiences. Participants and research context: Individual interviews (N = 8) and a focus (...) group interview with teachers (N = 9) from different nursing colleges were conducted. Ethical considerations: Ethical approval was granted and all participants signed their informed consent. Findings: Two overall themes emerged: (1) authoritarian learning climate, with three subthemes: (a) fear of making critical comments about clinical practice, (b) fear of disclosing mistakes and lack of knowledge and (c) lack of a culture of critical discussion and reflection that promotes moral competence; and (2) discrepancy between expectations on learning outcome from nursing college and the learning opportunities in practice comprising three subthemes: (a) gap between the theory taught in class and learning opportunities in clinical practice, (b) lack of good role models and (c) lack of resources. Discussion: Our findings indicated that showing respect was a central objective when the students were assessed in practice. A number of previous studies have enlightened the need for critical reflection in nursing education. Few studies have linked this to challenges experienced by teachers for development of moral competence in practice. This is one of the first such studies done in an African setting. Conclusion: There is a clear relationship between the two themes. A less authoritarian learning climate may enhance critical reflection and discussion between students, teachers and nurses. This can narrow the gap between the theory taught in college and what is demonstrated in clinical practice. Moral competence must be enhanced in order to ensure patients’ rights and safety. (shrink)

Purpose Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education. Methods From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year (...) and 109 third-year students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores. Results In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively. Conclusion During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission. (shrink)

The aim of this empirical study is to understand how bachelor students at universities of applied sciences (UAS) use their ethical compasses during internships. Semi-structured interviews were held with 36 fourth-year bachelor students across four UAS and three different programs in the Netherlands: Initial Teacher Education, Business Services, and Information and Communication Technology. To our knowledge, no studies appear to have investigated and compared students from multiple professional fields, nor identified the dynamics and the sequence of the strategies in (...) the decision-making process that students use when faced with ethical dilemmas during internships. We found that students’ ethical dilemmas stemmed from: mentors’ or managers’ behaviours/requests, colleagues’ behaviours, organisations’ morally questionable incentives, pupils’ home situations, and pupils’ behaviours/personal stories. The majority of students used multiple strategies and first investigated the ethical dilemmas they encountered and then avoided, intervened, delegated responsibilities, or adjusted to their environments. Students’ values played an important role in experiencing an ethical dilemma, however, these values were not always acted upon. We identified that rather students’ beliefs about having influence and/or ownership (or not), personal interest(s) and power relations influenced the way how they used their ethical compasses. Thus, instead of navigating on moral standards (of their profession), students reacted on beliefs which reflected the ways in which they constructed their internship contexts, social relationships and their own (and others) needs. As a result, half of the mentioned dilemmas were resolved in a prudent-strategic manner (e.g., by prioritising personal interests), instead of morally. This indicates that students did not always convert (moral) values into moral action and did not use their ethical compasses in the way UAS aspires. Finally, this study found that the ways in which students used their ethical compasses were strongly influenced by their environments. (shrink)

This edited volume presents a post-humanist reflection on education, mapping the complex transdisciplinary pedagogy and theoretical research while also addressing questions related to marginalised voices, colonial discourses, and the relationship between theory and practice. Exhibiting a re-imagination of education through themed relationalities that can transverse education, this cutting-edge book highlights the importance of matter in educational environments, enriching pedagogies, teacher-student relationships and curricular innovation. Chapters present contributions that explore education through various international contexts and educational sectors, unravelling (...) educational implications with reference to the climate change crisis, migrant children in education, post-pandemic education, feminist activisism and other emergent issues. The book examines the ongoing iterations of the entanglement of colonization, modernity, and humanity with education to propose a possibility of education capable of upholding heterogeneous worlds. Curated with a global perspective on transversal relationalities and offering a unique outlook on posthuman thoughts and actions related to education, this book will be an important reading for students, researchers and academics in the fields of philosophy of education, sociology of education, post humanism and new materialism, curriculum studies, and educational research. (shrink)

The teaching of ethics in teacher education programs is crucial for fostering the moral and ethical development of prospective teachers and shaping them into ethical role models for future students. This study, employing qualitative case study research, gathered data from undergraduates in teacher education programs to explore the best approaches for ethics education. It found that combining digital and case-based pedagogical methods, fostering an open-minded attitude among lecturers, and implementing a blend of Socratic and active learning techniques leads (...) to the most favorable outcomes. Additionally, continuous formative assessment throughout the academic year is essential. To cultivate a teaching workforce with strong ethical and moral values, undergraduate courses in ethics and morality should be thought-provoking, integrating real-life cases with a mix of digital and tangible resources. The ethics course lecturer should not only serve as a role model and exhibit a caring disposition but also use effective teaching methodologies. The paper details key themes and categories for successful ethics instruction and offers specific recommendations. (shrink)

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (...) (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country. (shrink)

How medical education and practice can move beyond a narrow focus on biological intervention to recognize the lived experiences of illness, suffering, and death. In Afflicted, Nicole Piemonte examines the preoccupation in medicine with cure over care, arguing that the traditional focus on biological intervention keeps medicine from addressing the complex realities of patient suffering. Although many have pointed to the lack of compassion and empathy in medical practice, few have considered the deeper philosophical, psychological, and ontological reasons (...) for it. Piemonte fills that gap, examining why it is that clinicians and medical trainees largely evade issues of vulnerability and mortality and, doing so, offer patients compromised care. She argues that contemporary medical pedagogy and epistemology are not only shaped by the human tendency to flee from the reality of death and suffering but also perpetuate it. The root of the problem, she writes, is the educational and institutional culture that promotes reductionist understandings of care, illness, and suffering but avoids any authentic confrontation with human suffering and the fear and self-doubt that can come with that confrontation. Through a philosophical analysis of the patient-practitioner encounter, Piemonte argues that the doctor, in escaping from authentic engagement with a patient who is suffering, in fact “escapes from herself.” Piemonte explores the epistemology and pedagogy of medicine, examines its focus on calculative or technical thinking, and considers how “clinical detachment” diminishes physicians. She suggests ways that educators might cultivate the capacity for authentic patient care and proposes specific curricular changes to help students expand their moral imaginations. (shrink)

Background Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. Objective The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without (...) clinical exposure. Research design A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. Participants and research context A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. Ethical consideration Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. Findings Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the ‘conflicts’ domain with increased clinical exposure. Conclusion Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings. (shrink)

This fascinating new book examines diversity in moral judgements, drawing on recent work in social, personality, and evolutionary psychology, reviewing the factors that influence the moral judgments people make. Why do reasonable people so often disagree when drawing distinctions between what is morally right and wrong? Even when individuals agree in their moral pronouncements, they may employ different standards, different comparative processes, or entirely disparate criteria in their judgments. Examining the sources of this variety, the author expertly explores morality using (...) ethics position theory, alongside other theoretical perspectives in moral psychology, and shows how it can relate to contemporary social issues from abortion to premarital sex to human rights. Also featuring a chapter on applied contexts, using the theory of ethics positions to gain insights into the moral choices and actions of individuals, groups, and organizations in educational, research, political, medical, and business settings, the book offers answers that apply across individuals, communities, and cultures. Investigating the relationship between people⁰́₉s personal moral philosophies and their ethical thoughts, emotions, and actions, this is fascinating reading for students and academics from psychology and philosophy and anyone interested in morality and ethics. (shrink)

A study of physicians and medical students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in medicine and their epistemological presuppositions in relationship to the subjective-objective controversy in value theory. The study revealed that most physicians and medical students tend to be objectivists in value theory, i.e., believe that value judgements are knowledge claims capable of being true or false and are expressions of moral requirements and normative imperatives emanating from (...) an external value structure or moral order in the world, but that most physicians and medical students are inconsistent in the philosophical foundations of their medical ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. The study also revealed that most physicians and medical students think more emphasis should be placed upon medical ethics in medical education. (shrink)

This volume investigates the role of the arts in character education. Bringing together insights from esteemed philosophers and educationalists, it looks to the arts for insight into human character and explores the arts' relationship to human flourishing and the development of the virtues. Focusing on the moral value of art and considering questions of whether there can be educational value in imaginative and non-narrative art, the nine chapters herein critically examine whether poetry, music, literature, films, television series, videogames, and (...) even gardening may improve our understanding of human character, sharpen our moral judgement, inculcate or refine certain skills required for virtue, or perhaps cultivate certain virtues themselves. Bringing together research on aesthetics, ethics, moral and character education, this book will appeal to students, researchers and academics of philosophy, arts, and education as well as philosophers of education, morality, aesthetics, and teachers of the arts. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine by Laurence B. McCullough, John Gregory’s Writings on Medical Ethics and Philosophy of Medicine ed. by Laurence B. McCullough, Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush by Lisbeth HaakonssenHeiner F. KlemmeLaurence B. McCullough. John Gregory and the Invention of Professional Medical Ethics and the Profession (...) of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xv + 347. Cloth, $140.00.Laurence B. McCullough, editor. John Gregory’s Writings on Medical Ethics and Philosophy of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xi + 254. Cloth, $105.00.Lisbeth Haakonssen. Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush. Amsterdam, Atlanta: Rodopi, 1997. Pp. x + 247. Paper, $20.50.The Scottish Enlightenment is widely appreciated for its contributions to philosophy, economics, sociology, law, chemistry, and medicine. The ideas and theories advanced by Hume, Smith, Millar, and Ferguson are still widely debated. John Gregory (1724–1773), important in his own time, is not as well known as some of his friends and colleagues. He was professor of medicine at the University of Edinburgh from 1766 to 1773, where he taught introductory lectures on the theory and practice of medicine. A set of extensive student notes from these lectures, entitled Observations on the Duties and Offices of a Physician, appeared anonymously in 1770. Two years later, Gregory himself published a revised version of his lectures under the title Lectures on the Duties and Qualifications of a Physician. These two books are said to mark the beginnings of professional medical ethics in the English-speaking world. They are also sometimes characterized as having anticipated bioethics.McCullough’s comprehensive John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine is the first modern intellectual biography of Gregory. Based on extensive research into eighteenth-century institutional context and the study of hitherto unknown manuscripts, he gives a full account of Gregory’s education at Edinburgh and Leiden, and his practice and teaching of medicine at Aberdeen, London, and Edinburgh. He stresses the importance of Gregory’s membership in the Aberdeen Philosophical Society and his close contact with Mrs. Montagu and her Circle for the understanding of his medical ethics. McCullough also shows that Bacon’s experimental method had a decisive influence on Gregory. Gregory took over Bacon’s three offices or ends of medicine: preservation of health, prolonging of life, and curing of diseases. In 1772, perhaps anticipating his premature death from hereditary gout, he added a fourth office, namely easing the pain of dying. Gregory referred mainly to Bacon (and Reid) in his Lectures to make clear how we can enlarge our medical knowledge by the method of experience and observation, pointing out that the progress of medicine had been seriously retarded by the way in which it was taught since Hippocrates. He also thought it was handicapped by the view that only professionals [End Page 535] should practice it, and claimed that even quacks have their advantages because their interest and reputation seldom suffer from the failure of the experiments necessary for the improvement of the medical profession.Gregory also argued that we should regard medicine not as a trade but as an art. In this context the principle of sympathy (or humanity) became important for him. Sympathy was the basis of the central duties in his Lectures. In a time of extreme instability of manners, when medicine was regarded more as a trade than an art, there was no physician-patient relationship based on the epistemological and moral authority of the physician. According to McCullough, it was Gregory who created “the physician-patient relationship as fiduciary. The virtues of the physician as fiduciary—openness to conviction, tenderness, and steadiness—provided for him the moral causes that would gather physicians together into a group worthy of the name, ‘profession,’ in its intellectual and moral senses” (265). The physician should no longer view his patients as moral strangers.McCullough claims that Gregory’s medical ethics is not just of historical interest, providing bioethics with its own history. It is also of... (shrink)

A novel method of teaching military medical ethics, medical ethics and military ethics in the Israel Defense Force (IDF) Medical Corps, essential topics for all military medical personnel, is discussed. Very little time is devoted to medical ethics in medical curricula, and even less to military medical ethics. Ninety-five per cent of American students in eight medical schools had less than 1 h of military medical ethics teaching and few knew the (...) basic tenets of the Geneva Convention. Medical ethics differs from military medical ethics: the former deals with the relationship between medical professional and patient, while in the latter military physicians have to balance between military necessity and their traditional priorities to their patients. The underlying principles, however, are the same in both: the right to life, autonomy, dignity and utility. The IDF maintains high moral and ethical standards. This stems from the preciousness of human life in Jewish history, tradition and religious law. Emphasis is placed on these qualities within the Israeli education system; the IDF teaches and enforces moral and ethical standards in all of its training programmes and units. One such programme is ‘Witnesses in Uniform’ in which the IDF takes groups of officers to visit Holocaust memorial sites and Nazi death camps. During these visits daily discussions touch on intricate medical and military ethical issues, and contemporary ethical dilemmas relevant to IDF officers during active missions. (shrink)

Professional ethics, in general, deals with justified moral values that govern the work of professionals. Profession is an expertise who is committed to promote a distinctive public good, such as learning or education. Professionals are committed to special duties to make services available, maintain confidentiality, secure informed consent for services, and be loyal to clients, employers, and others with whom one has fiduciary relationship. Professional ethics deals with theoretical issues which seek to understand how the justified moral values governing (...) professionals are linked to wider values. It also deals with practical issues as to how to apply duties in particular contexts. Professional values include principles of obligation and rights, virtues, personal moral ideals as manifested in the great lives. Given such a Western idea of professional ethics, it is indeed fascinating to trace professional ethics in the Upaniṣads. The Upaniṣadic sages since time immemorial have shown the path to peace and progress for all humanity, not only by laying down theoretical ideals or speculation, but by actually applying truths in their practical life. They have demonstrated the practical application of the ethical ideals or moral values in the personal and professional life and proved that self-realization alone can not only save man from misery but promote to the state of highest bliss. The standards laid down by them have been followed practically by people even today. Gītoponiṣad states that whatever action is performed by the great is imitated by the common people; whatever standard is set by him is followed by them. The Kaṭha Upaniṣad prescribes professional values to the extent that not he who has not ceased from evil conduct can obtain Him by knowledge. Good conduct as a value is thus emphasized here. In Taittirīya Upaniṣad, for instance, the teacher prescribes certain values in the form of commandments: speak the truth and practice virtue. Thus, it is evident that the Upaniṣadic teacher is not only concerned about the intellectual progress of the student but also its personal and professional life as well. The paper is a humble attempt to explore the roots of professional ethics in the Upaniṣadic ethics. (shrink)

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, (...) desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics. (shrink)

This unique collection of essays from researchers and teacher educators from around the world presents innovative approaches to education theory, critical policy analyses, de-colonializing reformulations of teacher education, and a "standard of dissensus" for teacher education. This first volume from the International Teacher Education Research Collective (ITERC), illustrates common themes and problems in politics of education, in particular, standardization, marketization, governance of and policy in education with both country specific cases and generally formulated theoretical discussions. The (...) book has three primary aims: to illustrate and critique the ethical, epistemological, and political discourses shaping teacher education; to identify and unravel the entanglements of politics, knowledge, and ethics in teacher education in a range of international settings; and, to revitalize teacher education by proposing and exploring alternative modes of thought and practice. The volume contributes to further reflection and in-depth discussion in education, to the formulation of new areas for educational research, and for critical resistance to hegemonic discourses of education. Making an important contribution to contemporary education discourse, this book is a useful guide for education researchers and theorists, teacher educators and postgraduate and higher degree research students in education. (shrink)