Preparing medical students for new challenges in medical ethics

(Richard Catabay, Unsplash)

This article was exclusively written for The European Sting by Mr. Franz Erich Lopez Gonzalez, a 5th year medical student at Universidad Autonoma de Santo Domingo (UASD) in the Dominican Republic, and the current LORE of SCORE in local IFMSA Chapter Organizacion dominicana de Estudiantes de Medicina (ODEM). He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

In the current age of technology, patient – physician relationships have changed considerably. Now the patients have access to a myriad of information online regarding their specific illness, and now with the advent of telehealth, patients can receive a consultation via Internet, without the need for a physician to be on the same room. Due to the change of paradigm in patient care, new ethical dilemmas arise (1). Is the new generation of physicians prepared to deal with these new challenges? And if not, how can we improve this situation?

To begin, Medical ethics education can be challenging, and even more because as studies suggest medical students will consider this topic to be of less importance compared to others (2) Therefore the approach used by professors to teach this topic needs to be a little unconventional because medical students will prefer more and will engage more with team based learning and problem based learning over conventional methods such as lectures and multiple choice question based examination. (2,3,4)

So what are the ethical problems that new physicians will have to face? Due to the high volume of information available to the public online, questions on the fidelity and competence of the writers comes to mind, also because of the indirect nature of the patient – physician relation when using telemedicine services, there may be violations on the confidentiality of the interaction (1). A trending topic nowadays it’s the ethics of stem cell research and transplantation, because it deals with the philosophical questions of “What is life?”, “When does life starts?”  And in the case of transplantation, “when does life ends?” (5). It is Imperative that future physicians become oriented in these topics, so that when faced with a particular scenario, they will have the tools necessary to make a rational decision taking in consideration the cultural and religious aspects that these topics entail.

In conclusion, Eckles et al (2) state that, many authors agree in that ‘the goal of ethics education should be to provide a set of skills for ethical analysis and decision making’ (p.1145). To complete this goal, in this era of technology, it is important to review the current methodology of teaching medical ethics, so it includes trending topics like telehealth, stem cell research and transplantation. Also the importance of medical ethics should be stressed, so that the mindset of the student becomes one in which no class is better than the other, and all of them will become a skill that will lead him to be the best physician he can, prepared to take on any challenge.

References

(1) Chaet D, Clearfield R, Sabin JE, Skimming K, Association  on behalf of the C on E and JAAM. Ethical practice in Telehealth and Telemedicine. J GEN INTERN MED. 2017 Oct 1;32(10):1136–40.

(2) Eckles RE, Meslin EM, Gaffney M, Helft PR. Medical Ethics Education: Where Are We? Where Should We Be Going? A Review. Academic Medicine. 2005 Dec;80(12):1143.

(3) Ozgonul L, Alimoglu MK. Comparison of lecture and team-based learning in medical ethics education. Nurs Ethics. 2019 May 1;26(3):903–13.

(4) Bilgin AC, Timbil S, Guvercin CH, Ozan S, Semin S. PRECLINICAL STUDENTS’ VIEWS ON MEDICAL ETHICS EDUCATION: A FOCUS GROUP STUDY IN TURKEY. Acta bioethica. 2018 Jun;24(1):105.

(5). Raza M, Dharamshi HA, Ahsan SZ, Naqvi Z, Naqvi T, Ali AAM, et al. The Future of Ethics in Medicine. Iranian Red Crescent Medical Journal [Internet]. 2016 Jun [cited 2019 May 19];18(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003096/

About the author

Franz Erich Lopez Gonzalez is a 5th year medical student at Universidad Autonoma de Santo Domingo (UASD) in the Dominican Republic, and the current LORE of SCORE in local IFMSA Chapter Organizacion dominicana de Estudiantes de Medicina (ODEM). Also, he is an Active member of Dominican Red Cross, Teacher assistant for pharmacology classes, and a guitar player/teacher as a hobby.