Rawls (1999) characterises systems of law in this definition:
“A legal system is a coercive order of public rules addressed to rational persons for the purpose of regulating their conduct and providing the framework for social cooperation. When these rules are just they establish a basis for legitimate expectations. They constitute grounds upon which persons can rely on one another and rightly object when their expectations are not fulfilled. If the bases of these claims are unsure, so are the boundaries of men’s liberties.”
These ideas of conduct, responsibilities, entitlements, and freedoms are plainly as ethical in their nature as they are legal. Rights discourse entails, as Kennedy (1988) notes, “broad over-arching legal as well as ethical principles against which any proposed legal measure must be tested and approved”. This embraces not only “those rights declared in international Conventions or set down in the Constitutions or Charters of particular nations, but also those inchoate rights which are the product of reasoned moral analysis”.
Beyond the family association, however, a more compelling reason to maintain the linkage between medical law and ethics in the curriculum is to help prepare our students for their own clinical practice. The moment a patient comes into the treatment room, the medical professional is instantly placed in both an ethical and a legal context. Purely to act within the provisions of law may not be sufficient to meet professional standards as set out by governing bodies. Similarly, the practitioner who reasons solely according to an otherwise justifiable ethical position may be acting outside of the legal requirements. Box 9 indicates how the two domains interrelate.
BOX 9 Linkage between ethics and law
...a more compelling reason to maintain the linkage between medical law and ethics in the curriculum is to help prepare our students for their own clinical practice.
Ethical domain
Legal domain
Self-directed practice: Obligation guided by principles, values, and responsibilities in connection with relevant, ordinate interests that may or may not be provided for in the law
State-sanctional practice: Obligation within a formal system of entitlements and duties as specified in the law, which is subject to criteria of ethical and socio-cultural standards
There may be the assumption, however, that only teachers qualified in academic law are in a position to engage this technically daunting subject area. As a medical teacher, after all, your expert knowledge probably lies in another specialty entirely! Yet you also have a strong commitment, arising from that professional perspective, to the ethics learning of students without necessarily holding a relevant degree in the field. The reason you are less hesitant about engaging the ethics curriculum is that the educational goal is not to acquaint students with a thorough philosophical grounding in ethical theory. The distinction is between students receiving a relevant ethics education as opposed to training in expert knowledge as ethicists. In terms
Guide 53: Ethics and Law in the Medical Curriculum 13
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