Essay on Teaching Medical Ethics

Concern over the teaching and learning of medical ethics has evolved over the past 30 years. A “coming of age” process is described in two national reports on the emergence and establishment of medical ethics education and continues today.

Medical ethics literature is often more exhortative than empirical. When based on the qualitative experiences of the writer(s), it does not usually meet the criteria required of qualitative research. Medical schools describe competence in both the scientific aspects of disease and the humanistic aspects of patient care as necessary outcomes, but wide variation exists in the weight and priority given scientific v. humanistic values in the curriculum.

On the other hand, while the literature on medical ethics education is sparse in comparison to medical literature that is disease or technique related, I believe that it must also be noted that biomedical education literature is equally or more limited. No clear consensus exists on the content or the approach best able to imbue students with its desired outcomes. For example, several studies found that pre-clerkship ethics instruction that was illness-specific (e.g. AIDS) and provided identification of personal support systems for the medical student was effective in minimizing or avoiding concerns that resulted in discrimination and bias when providing treatment. Unfortunately, “new” illnesses cannot be anticipated.

Nor can new technologies that will raise ethical questions about existing illnesses or evolving support methods such as internet support groups. It is important to identify and minimize existing problems, but a problem for medical ethics education is that it must also be proactive toward fixture actions. It must also identify ways to successfully prepare future physicians to deal with new issues that arise over the course of their careers. Prior to 1967 when an ethics program was instituted at Pennsylvania State University College of Medicine, neither medical ethics nor medical humanities existed as a field of study.

Initially, most medical schools began formal instruction in ethics by incorporating ethics content into the professional curriculum as units of other courses. The current trend is for schools to require separate courses in medical ethics in increasing numbers. However, no consensus exists on this trend or the other options. Should medical ethics education support the trend away from an embedded approach? Is it better to incorporate specific classes on medical ethics into existing basic medical course plans?

Thesis on the Symptoms of ADHD

ADHD is a neurological disorder of the executive features of the brain. ADHD people have difficulty with self regulation, concentration, and organisation. It stands for hyperactivity disorder of attention deficit (ADHD).

Symptoms of ADHD includes:

  • Lack of attention
  • Bad Time Control Management
  • Poor management of impulses
  • Exaggerated thoughts
  • Hyperfocus phenomenon
  • Overactivity
  • Dysfunction of executives

Symptoms of ADHD differ by person. Some or only any of the above symptoms can be encountered by you or your infant, along with those detailed in the DSM-V. ADHD is characterised by many patients and physicians as an iceberg, where most signs lie buried beneath the sea, out of sight but ever present. Take one of our free , confidential tests below to see whether you can get a formal diagnosis whether you believe you or a loved one may have ADHD.

Thesis on The MMR Hypothesis

MMR Hypothesis

The tale of how vaccines were brought into question as a cause of autism stretches back to the 1990s. In 1995, a cohort study was published in the Lancet by a group of British researchers finding that people who were infected with the measles-mumps-rubella ( MMR) vaccine were more likely than people who had not administered MMR to develop bowel disease.

Gastroenterologist Andrew Wakefield, MD, was one of these researchers, who went beyond that to investigate the potential correlation between the vaccine and bowel disease by speculating that chronic vaccine virus infection triggered intestinal tissue damage, which in turn contributed to bowel disease and neuropsychiatric disease (autism in particular). Any studies have recently indicated that part of this theory is that vaccination is linked with autism.

Wakefield conducted a case series report in the Lancet in 1998, along with 12 co-authors, reporting that they find signs of measles virus in the digestive tracts of children who had shown autism symptoms after MMR vaccination in many of the 12 cases they examined. He proposed the suspension of the MMR combination vaccine in favour of single-antigen vaccines offered individually over time.

The probability of a correlation between MMR and autism was comprehensively investigated over the next twelve years. No reputable, valid research supported the results of Wakefield; instead, there was no correlation between MMR and bowel disease or MMR and autism in several well-designed trials.

The BMJ released a report by Brian Deer. Deer consulted with parents of children from the retracted study for this new report and found evidence that Wakefield perpetrated test deception by falsifying details regarding the circumstances of the children.

Deer noticed after reviewing the records for all twelve children that the claims made in the paper did not fit the numbers from the records of any of the following categories: children with regressive autism; children with non-specific colitis; or children with original signs within days of acquiring the MMR vaccine. The Lancet paper argued that six of the children had all three of these conditions; not a single child really did, according to the documents.

While scientists have long debunked the conclusions of Wakefield ‘s paper, the proof that the research itself has been falsified renders this study by the BMJ a seminal event in vaccine history. There is clear evidence that the initial thesis may not have been conducted because it was not only improperly performed, and moreover that it was a result of scientific fraud.

Thesis on Changes in Medical Practice

Over time, social and technological changes have led to changes in medical practice and the erosion of a caring ethic. Too many patients, the image of a doctor is akin to a Norman Rockwell painting of the kind, gentle, fatherly man who makes house calls, patiently holds hands and seems intuitively attuned to his patients’ needs. Doctors, too, identify with this image as a role model.

But the world of the modern doctor is far removed from this idealized picture. Societal and technological factors have created complicated and impersonal health care settings and experiences for most patients and physicians. What Rockwell did capture was a sense of caring and trust between physicians and patient which many people considered and still consider the cornerstone of both a good relationship and good medical care.

The medical care he was depicting, representing the medical care in the 1940s, was often conducted in the private realm of the home. Patients were born there, had children and illnesses there and died there. People survived serious ailments, infections and disease with little or no assistance from medical technology, or died.

Physicians could not offer effective treatments for most diseases but they did try to alleviate suffering and pain. Physicians treated illnesses of entire families and extended families and very often had long-term inter-generational relationships with their patients. By the 1980s, however, the Rockwell image no longer pertained. Few patients were seen by family doctors and few, even within the same family, were seen by the same doctor.

The family physician providing home care had faded away and the close and inter-generational relationships were lost. One explanation for the changes in medical practice is found in the scientific and technological revolution that has and is occurring at academic medical centers (“AMCs”). AMCs with their research facilities, their hospitals, and their medical schools are the primary location for change in medical practice.