The course is structured in the following way:
- Chapter one introduces the course with a description of medical ethics and a discussion of its importance for the practice of medicine.
- Chapter two deals with the difference between medical ethics and other ethics and with how individuals make ethical decisions.
- Chapter three focuses on the patient-physician relationship, including beginning-of-life and end-of-life issues.
- Chapter four deals with the relationships between physicians and society.
- Chapter five is concerned with the how physicians relate to other physicians, to medical students, and to other health care providers.
- Chapter six introduces the basic ethical requirements for medical research involving human subjects.
- Chapter seven concludes the course with some reflections on the privileges and responsibilities of physicians and the future of medical ethics.
The inspiration for this course was the 51st World Medical Assembly in 1999, at which time the World Medical Association, the global representative body for physicians, decided: “that the WMA strongly recommend to Medical Schools worldwide that the teaching of Medical Ethics and Human Rights be included as an obligatory course in their curricula.” In line with that decision, the plan was implemented to develop an on-line course on medical ethics for all physicians that would be based on WMA policies but not be itself a policy document.
Modern health care has given rise to extremely complex and multifaceted ethical dilemmas, and at times physicians are unprepared to manage these competently. This course is specifically structured to reinforce and strengthen the ethical mindset and practice of physicians and provide tools to find ethical solutions to these dilemmas. It is not a list of “rights and wrongs” but an attempt to sensitize the conscience of the physician, which is the basis for any sound and ethical decision-making. In this vein, you will find several case studies in the course, which are intended to foster individual ethical reflection as well as discussion within team settings.
As physicians we know what a privilege it is to be involved in the patient-physician relationship, a unique relationship facilitating an exchange of scientific knowledge and care within a framework of ethics and trust. The course is structured to address issues related to the different relationships physicians are involved in – with patients, their family members, employers, governments, commercial enterprises, research institutions – but the core will always be the patient-physician relationship. In recent times, this relationship has come under pressure due to resource constraints and other factors, and this course shows the necessity of strengthening this bond through ethical practice.
Lastly a word on the centrality of the patient in any discussion on medical ethics. Most medical associations acknowledge in their foundational policies that ethically, the best interests of the individual patient should be the first consideration in any decision on care. This course will only succeed if it amplifies this imperative – TO PUT THE PATIENT FIRST.