Medical Ethics and Professionalism
The goal of Medical Ethics and Professionalism at Mercer University School of Medicine is to increase your ability to recognize, analyze, and respond to issues in Medical Ethics and Professionalism. To do this, we use a combination of lectures, readings, case discussions, and submission of papers. We start with the most general topics in the first year (principles of ethics, informed consent, and confidentiality), to examining the integrity of medical evidence in the second year, to a variety of topics particular to each specialty in the third year. Suggested topics for each clerkship are described in the following pages, but they are not adhered to rigidly. When a topic in the news is "hot," when a case seen during the clerkship poses important questions, or when a faculty member available for a clerkship has special expertise, the suggested topics may give way. But students should be aware that the topics described are important in those specialties, and those planning on going into a specialty would be well-advised to become familiar with ethical dilemmas related to that specialty. For those wishing further involvement in Medical Ethics and Professionalism, there are opportunities for individual mentoring, electives, research and publication.
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.
- What are the relevant medical issues (e.g., removal of feeding tube, transfusion, prescription of opiates for chronic non-malignant pain)?
- Who are most affected by the decision, i.e., the stakeholders (e.g., patient, family, physician, hospital)?
- What is the central ethical question(s) put by the case?
- What are relevant statutes, case law, ethical/professional codes, etc.?
- What additional resources might be helpful (e.g., ethics committee, medical consultations)?
- What are the available (i.e., the possible, reasonable) answers to the central question(s)?
- What reasons support each of these answers?
- Are these good reasons or are they vulnerable to serious objection?
- Which answer to the central question is best? Why?
- 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.