Course helps medical students deal with ethical issues in class
An Emory medical school course is helping students learn to deal with the
types of ethical dilemmas faced each day by practicing physicians.
The third-year course, called "Clinical Ethics," is a collaborative
project of the medical school and the Ethics Center. It introduces students
to resources the average doctor might not be familiar with, such as ways
to access the legal system for assistance in ethical dilemmas.
Legal guidance might be helpful if there is division within a family about
whether or not to continue life support, as demonstrated by a recent case
encountered by an Emory physician. A patient dying of painful metastatic
breast cancer, although she was delirious and confused, asked to have all
drugs, chemotherapy and life support withheld--yet the patient's family
wanted to take all possible measures to prolong her life.
"If we can imprint the skills for ethical decision making on students
at a formative stage of their professional development, we believe it will
have a lifelong impact," said course co-director and Emory psychiatrist
Alan Stoudemire. "This may be one of the most helpful things we can
impart to medical students."
Many of the cases students deal with involve the compassionate care of terminally
ill patients. In pediatrics, for example, a case might deal with the dilemma
of continuing life support in a premature infant with brain damage. In internal
medicine, it might deal with whether or not to continue nutrition in a patient
with Alzheimer's disease who is in a vegetative state. In surgery and anesthesia,
the debate might involve whether or not to continue respirator support in
a patient with severe head trauma who will not recover cognitively. In obstetrics
and gynecology, students might discuss issues of surrogate parenting, ethical
issues of selective termination of pregnancy in multiple births, or prescribing
contraceptives for underage teenagers.
"Not only will we be graduating medical students who are well informed
about medical ethics, but we also will be increasing faculty members' levels
of knowledge and sensitivity in ethical matters," Stoudemire said.
Under the guidance of Stoudemire and course directors Kathy Kinlaw, associate
director of the Ethics Center, and Mary Lynn Dell, assistant professor of
psychiatry, students study medical ethics cases relating to the specialties
through which they rotate during their third year.
"This is not an equation, but simply a framework around which to organize
their thinking," Kinlaw said.
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