11 A
1. Refer students to the Hadford University lecture announcement, and tell them to look at the title and the summary of the talk. Elicit some ideas on what the lecture will be about.
2. Elicit ideas on the most appropriate method of making notes. Give students an opportunity to prepare their page in their notebook and to compare it with a partner.
Suggested answers
T e lecture follows the format for theories and opinions and then supporting information. T e most appropriate format is a two-column table or the Cornell system (which is used here).
B
Set for individual work and pairwork checking. Explain to students that they will need to make notes as they listen and that they should work together, using their notes, to answer questions 1–4. Give students time to read the questions.
54
Play Part 1 once. Give students time to share their notes and attempt to answer the questions. Elicit and feed back the answers to the class, building a set of notes on the board. Add the examples to the spidergram from Lesson 11.1.
Ask students which method they are going to use to make notes now that they have listened to the introduction. T ey should make any adjustments necessary to the page they have prepared in their notebooks.
Answers 1. medical ethics 2. ethical and legal issues relating to patients
3. patients who want to end their own lives, women past child-bearing age who want to have children, patients demanding non-standard treatments, when to stop life support for elderly patients
4. autonomy vs benefi cence, autonomy vs justice (and possibly nonmalefi cence), justice and autonomy vs benefi cence
54 Part 1
Good morning. My name is Dr Meera Singh, and much of my work has been in areas related to medical ethics. I’m here today to give you an overview of ethical and legal issues you are likely to consider when dealing with
222
Play Part 2 once without stopping. 55
Part 2
To start with, it is important to understand the background to the current ethico-legal framework in which doctors have to operate. To some degree, what we understand by medical ethics goes back as far as the 4th century and the establishment of the Hippocratic Oath. It is often assumed that the principles underpinning this have simply been refined and developed over time by the legal and medical professions to give us our current ethico-legal framework. Actually – and this may surprise many of you – the starting point for current ethical standards only dates back to 1945, when the Nuremberg Code was drawn up. At the end of the Second World War, it became clear that, during the war, many medical experiments in Germany caused great suffering, to the extent that thousands of prisoners died or were disfigured. A case in point is the experiments in which prisoners were immersed in ice-cold water to measure how long they could survive. It was primarily to clarify what was acceptable in the
conduct of experiments on humans that the Nuremberg Code was drawn up. At the centre of the code was the need for the voluntary consent of the human subject to any procedures they would undergo. Weindling gives a very good description of the process in his book Nazi Medicine and the Nuremberg Trials, which was published in 2004. However, while it provided ethical guidance in
the context of experimentation on human subjects, the Nuremberg Code did not concern itself with the
11.2 Listening
patients; that is to say, I am going to look at the ethico- legal issues relating to treating patients. Don’t misunderstand me – I don’t want you to assume
that medical ethics are relevant only when dealing directly with patients. As we all know, to some degree, ethical considerations will form a part of every decision you make as a doctor, regardless of your role. However, it’s fair to say that legal and ethical issues are most apparent when dealing directly with patients. Not only that, but they become more emotional as well. We can think of many such cases – for example, patients who want to end their lives because of their condition; women past childbearing age who want to have children; patients who demand non-standard treatments; and when to stop life support for an elderly patient. As you can see, the range of situations which might raise ethical questions is very wide indeed. So, in an attempt to keep our discussion of ethical issues reasonably focused, I’m going to summarize the background to some of the key issues around consent in patient treatment and clinical research.
C
Tell students you will play Part 2 of the lecture without stopping. Explain that they should make notes in the format they have chosen.
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