Doctors make medical ethics plea

Medicine is moving rapidly

Doctors are calling on the government to fund a review into the standard of ethics training in medical schools.

The British Medical Association says doctors need more help to deal with the complex ethical issues that are part of modern medicine.

These range from questions about the rights of unmarried fathers to withdrawing treatment from terminally ill patients.

The BMA has attempted to address some issues in a new handbook.

There has never been such an important role for medical ethics Dr Vivienne Nathanson

Dr Michael Wilks, chairman of the BMA Medical Ethics Committee, said: "There is no doubt that the public's confidence in doctors took a severe knocking after the Alder Hey and Bristol Royal Infirmary hospital scandals and we need to restore this.

"Modern doctors are increasingly expected to have analytical skills and an understanding of the law but we know from the calls we receive that they often feel unprepared for such roles."

Dr Wilks said the BMA receives thousands of enquiries every year from doctors needing assistance with ethical issues.

In just one week at the end of November its online ethical guidance was accessed by more than 1,400 visitors.

Quality issues

Although medical ethics is now an accepted part of undergraduate courses, experts strongly suspect that the quality and quantity of teaching varies considerably.

A comprehensive review of UK ethics teaching, published by the Institute of Medical Ethics in 1987, recommended another evaluation should take place within five years. But this has never happened.

The BMA says a new and thorough review is needed to establish how effectively medical ethics and basic law are being taught and identify how the system can be improved.

Professor Raanan Gillon, deputy chairman of the BMA Medical Ethics Committee, said: "We know that some medical schools have excellent programmes but others seem to be lagging far behind.

"This puts doctors and patients at risk of bad decision making and legal action.

"Since there has been virtually no comparative evaluation of the different teaching models used across the UK, we still do not know what works best.

"Just as medicine should be evidence-based, so should our education programmes be based on what actually works."

Guidance

The BMA's new handbook - Medical Ethics Today - covers a wide range of ethical issues.

Dr Vivienne Nathanson, the BMA's Head of Science and Ethics, said rapid advances in medical technology had raised many new issues.

She said: "Doctors can be involved with decisions concerning withdrawing and withholding treatment, approaching bereaved families about organ donation and assisted reproduction.

"Indeed there has never been such an important role for medical ethics to help guide doctors in their everyday decisions."