The culmination of Medical Ethics and Professionalism at Mercer is the Senior Paper. (requirements for and examples of senior papers are described under the Senior Papers tab on this site).  Thus the aim of the first three years is to provide the knowledge and skills necessary to analyze and present a problematic situation involving ethics or professionalism encountered by the student.  In the first two years, background on important topics in Medical Ethics and Professionalism (e.g., informed consent, confidentiality, research ethics) is presented in lectures, and cases involving those topics are analyzed in small groups.  In the third and fourth years, special topics relevant to particular medical specialties are discussed.   

The ethical questions raised by the cases are made explicit and are addressed using a structured format developed at mercer (see First Year tab for case analysis format).  An adequate case-analysis includes answers to the following questions.

1. What are the relevant medical issues (e.g., removal of feeding tube, transfusion, prescription of opiates for chronic non-malignant pain)?
2. Who are most affected by the decision, i.e., the stakeholders (e.g., patient, family, physician, hospital)?
3. What is the central ethical question(s) put by the case?
4. What are relevant statutes, case law, ethical/professional codes, etc.?
5. What additional resources might be helpful (e.g., ethics committee, medical consultations)?
6. What are the available (i.e., the possible, reasonable) answers to the central question(s)?
7. What reasons support each of these answers?
8. Are these good reasons or are they vulnerable to serious objection?
9. Which answer to the central question is best?  Why?
10. Given a particular answer to the central question and given the peculiarities of this case, what should the physician do?

Notice that the focus of an ethical analysis is as much on why the physician should act in one way rather than another as on which way it is he should act.  It includes reasons for believing one course of action is better than another (or reasons for believing there is more than one reasonable course and, perhaps, no reason to prefer one to the other).

You will be expected to be able to give reasons for the choices you make as a physician to your patients, to their families, and to the people with whom you work—and to give reasons that take into account the objections that can reasonably be raised by those who might see the issues somewhat differently.

 First Year Courses

Basics of Clinical Ethics.  4 hrs.  Guiding concepts of care and human
rights; informed consent and the right to refuse treatment; decision making for patients who lack capacity; medical confidentiality; and and introduction to professionalism through analysis of the Oath of Geneva.  February of the first year.

Second Year Courses

• Ethics of Clinical Research.  4 hrs.  Ethical responsibilities of clinical
  investigators and of physicians who enroll patients in clinical trials. September of the second year. 
   
• Medical Student Ethics. 1 hr.  Ethics of using patients as "learning tools" and issues arising from hierarchies in medical practice and education.  The impaired student and physician.  September of the second year.
   

   Third-Year Clerkship Courses

  Clerkship	Family Medicine	Internal Medicine	Ob/Gyn	Pediatrics	Psychiatry	Surgery
  # of Sessions (w/total time) / rotation	1 (1.5 hours)	2 (3 hours)	3 (3 hours)	4 (4 hours)	2 (2 hours)	1 (1 hour)
  Topics	· Medical Error	· End-of-life care	· Maternal-fetal conflict · Reproductive Technologies · Ethics and the law	· Various-topics from resident experiences	· Capacity · Involuntary Treatment/ Institutional-ization · Duty to Warn	· Impaired physicians · Various

   Fourth-Year Clerkship Course

  Clerkship	Emergency Medicine
  # of Sessions (w/total time) / rotation	· 1 (1.5 hours)
  Topics	· Various