of educational philosophy, education is understood as an opening out and training as a concentration of focus (Downie et al., 2000).


A similar distinction applies to student learning in medical law: the goal is to develop an understanding of the legal framework within which clinical practice takes place, in contrast to achieving a technical mastery of the law. If we may consider an analogy with learning to drive, new road users require a practical knowledge of the code governing traffic on the highway, rather than scholarly expertise in the underlying legislation. Furthermore, even as beginners, learner drivers are themselves accountable within that framework while still learning to drive. The parallel between law and ethics in medical education is the emphasis of both upon clinical practice. Williams & Winslade (1995) agree that medical teachers need not hold a qualification in academic law in order to engage relevant medical law in the curriculum.


Some students (and other medical teachers) have been known to comment that the attention given to law means there is ‘hardly any ethics in the course’! The key to this misunderstanding is in the content of Box 8, as they are likely to be thinking of other types of ethics, with a probable emphasis on theory. But ethics as practical reason is primarily concerned with what we do, with the characteristic habits of our practice, and is thereby located within a legal framework, so that to speak of medical ethics is necessarily to speak also of medical law.


Summary


The word ‘ethics’ means different things to different people. In this AMEE Guide, it means professional ethics in medicine, and is an understanding of ethics as practical reason. Consequently, the ethics education of our students is directed both to what they do and to how they reason in professionally- oriented practice. There is a fundamental linkage of medical ethics and medical law, and this should also be maintained in the curriculum.


For Scott (1997) the goal of ethics education is that, “ethics is taught in an attempt to help the student become a better practitioner, better in the sense of more humane, more compassionate, more caring towards the persons who are the practitioner’s patients”. Miles et al. (1989) observe that, “the final goal of medical ethics education is to endow physicians with ‘practical wisdom’”. The next chapter unpacks some of the emphases of this practitioner wisdom, or practical reason, that will provide a rationale for our selection of course content within a professional ethics frame.


14


Guide 53: Ethics and Law in the Medical Curriculum


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