personal (experience), process (operational competences), and the ethical. Parker & Dickenson (2001) explain that the professional turn in medical law and ethics is not a recent phenomenon; the southern European professional codes dating from the 19th century (notably of France and Italy) formalise a legal and ethical relationship whereby patients, in exercising responsibility for their own health, are expected to cooperate with the advice of doctors, whose duty in turn is to provide the medical treatment needed.
As a frame for learning in professional ethics, Box 11 offers a set of key emphases that can be used both for selecting course content and also for unpacking this with students in learning situations. In terms of the options illustrated earlier in Box 6, this places ethics as ‘figure’ without occluding the underlying ‘ground’ of law.
BOX 11 One way of framing an account of professional ethics
society consequences everyday ETHICS intentions habits theory-based
Everyday
It is a common misconception that medical law and ethics is centred on the challenges presented by the development of novel treatments and innovative technologies. Seedhouse (1998) points away from this to the idea of everyday ethics, but restricts it to the “largely unanalysed reactions to life situations and dilemmas”. The everyday ethics experienced by the generality of doctors, however, is much more likely to be the regular and the ordinary in the professional obligations associated with routine clinical practice (UK Consensus Group, 1998; Goldie, 2000).
Medical law and ethics are not to be identified with ‘issues’ and ‘problems’. Commenting on the confusion that, “medical ethics tends to concentrate on what are called ‘dilemmas’”, Macnaughton (2001) notes that complaints about doctors often relate to behavioural or attitudinal matters. Hafferty & Franks (1994) criticise the emphasis on ethical quandaries, and propose instead that, “the goal is a ‘routine’ and ‘everyday’ place for ethics within the scientific and medical communities” (1994). As Campbell et al. (2007) observe:
“It is a fundamental point in medical ethics that there are ethical dimensions in all medical encounters, the non-dramatic as much as the dramatic. Thinking of medical ethics as a subject concerned only about critical decisions is a mistake.”
The everyday ethics experienced by the generality of doctors, however, is much more likely to be the regular and the ordinary in the professional obligations associated with routine clinical practice.
It is a fundamental point in medical ethics that there are ethical dimensions in all medical encounters, the non-dramatic as much as the dramatic. Thinking of medical ethics as a subject concerned only about critical decisions is a mistake.
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Guide 53: Ethics and Law in the Medical Curriculum
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