and through cultural genres of language and creative expression, by which students may connect their own lives with a sense of shared humanity. Macnaughton (2001) comments that works of literature demand “an emotional response from their readers and in doing so they will allow the students to discover their own hidden values and prejudices and to challenge them”. By holding a mirror up to our natures (a reference from Hamlet, Act III Scene II, relating – significantly – to the ‘play within a play’), this in turn promotes “the kind of self-understanding… which is essential for the development of mature human beings who are attuned and sympathetic to the perspectives and values of other people”.
Highlighting the place of emotional education in ethics learning, Allmark (1998) observes that, “getting emotions right involves the cultivation of sympathies, such as anger at injustice, compassion for the ill and suffering”. Wolf et al. (1989) comment on the dehumanisation that can occur in medical education, with expressions of cynical attitudes progressively increasing and expressions of humanitarian feelings progressively decreasing through the undergraduate years, though Miles et al. (1989) do not view ethics education itself as a solution to this. It may offer some counterpoint, however, in the endeavour described by Downie et al. (1997) as ‘humanising medicine’, and approaches to this are mapped out by Macnaughton (2001).
Still focusing on the scheme of the ‘person’, learning in ethics and law can also be mediated through a human rights perspective (Beauchamp & Childress, 2009). The World Medical Association (1999) strongly recommends that medical schools should include ethics and human rights “as an obligatory course in their curricula”. Responding to the rights of another person is simultaneously to acknowledge that individual as a human being and, in so doing, fundamentally to connect with our own humanity. This understanding offers tremendous potential for the ethico-legal curriculum. Kennedy & Grubb (2000) comment that medical law is “rich with and informed by human rights notions”. Pivotal to these notions is the distinction between ethical rights (which may be open to deliberation) and freedoms or entitlements that are legally protected (to a qualified extent, usually). Student learning in this scheme would interact with the underlying values that inform rights discourse, together with the protections that are provided for in the legal framework. Regarding ethical value and legal fact, Montgomery (2006) comments as follows:
“Whether or not you accept that human rights are objectively valid, they have been accepted by society and can draw their force from a contractarian basis of (implied or imputed) mutual consent… human rights can be said to describe those aspects of people’s well-being where infringement is seen as causing the sort of harm that justifies intervention”.
The Council of Europe Convention for the Protection of Human Rights and Fundamental Freedoms (1950, amended 2010) deals mostly with prohibitions, conferring freedoms from infringement of citizens’ rights rather than providing specific entitlements. Box 17 indicates the chief Convention articles that tend to be engaged in connection with medical care. For example, the freedom associated with right to life is not interpreted as an absolute right of the foetus, nor as a legal right to end our lives at a time of our own choosing through clinically assisted dying (Corfield et al., 2009). Neither is the prohibition
Responding to the rights of another person is simultaneously to acknowledge that individual as a human being and, in so doing, fundamentally to connect with our own humanity.
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Guide 53: Ethics and Law in the Medical Curriculum
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