Page 24 - HA Convention 2016 [Abstracts (Day 2)]

HOSPITAL AUTHORITY CONVENTION 2016 Special Topics

T13.1 Challenges of Biomedical Ethics in Modern Medicine: 13:15 Theatre 1
From Training to Practice

Is Medical Ethics a Teachable Subject?
Joynt GM
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong

Medical Ethics is a multifaceted subject, and potentially taught in many different ways. Teaching medical ethics through
promoting reading on ethical issues, or delivering lectures may promote knowledge. Such didactically taught knowledge
is usually enhanced by allowing students to attempt to resolve hypothetical cases in interactive guided sessions, thus
promoting experiential knowledge. As learning medicine is fundamentally an apprenticeship, role modeling ethical behaviour
is a potentially important teaching tool. This is particularly important, as our teaching outcome should be ethical behaviour. If
we were to teach our students well in all the above ways, it seems reasonable to expect that they should be able to learn, and
apply medical ethics to medical decision-making and develop appropriate ethical behaviour.

Unfortunately, some data from our students, and others, suggests that students do not become more ethical as they progress
through medical school. Examining their ethical knowledge, by judging their moral decisions, leaves us concerned that we
have taught poorly, or is it that despite good teaching, have they failed to learn? The results of our medical student answers
to questions related to honesty and full disclosure (key ethically driven behaviours), suggest several conclusions. Firstly, their
self reported views on honesty and full disclosure suggest their behaviour is less likely to be ethical as they progress through
medical school. Secondly, while medical students can certainly be taught to recognise what generally acceptable moral
decisions and actions are, their perceptions of appropriate moral behaviour of their teacher as a “role model” fall short of
such generally acceptable moral decisions and actions. This discrepancy between what they are taught, and what they learn
through observation and experience as part of their apprenticeship may explain the apparent failure to teach medical ethics
successfully.

While the reasons for apparent deterioration in some aspects of ethical decision-making behaviur in medical students during
their training are no doubt complex, the failure of our “role models” to adequately “teach” ethical behaviour must be explored
if we are to make ethics a consistently teachable subject.

T13.2 Challenges of Biomedical Ethics in Modern Medicine: 13:15 Theatre 1
From Training to Practice

Wednesday, 4 May How to Continue Biomedical Ethics Education at the Postgraduate Level
Kumta S
Centre for Bioethics, The Chinese University of Hong Kong, Hong Kong

A biomedical ethics curriculum for undergraduate students should enable students to develop the capacity of substantial
ethical enquiry-based in a moral framework. Discussing and deliberating the complexities in decision-making in the
background of moral and ethical theories is necessary for successful resolution of the complex dilemmas in practice.

What is learnt at a theoretical, almost abstract level, needs to be put into practice as a professional – especially during
postgraduate medical training – which in Hong Kong and most modern societies, is through in-service training.

A receptive environment within which ethical practices are the norm and transgressions are identified and duly addressed;
exemplary ethical behaviours are the defined standard and role models who display leadership and courage define the ethical
culture of an organisation.

It is within such a supportive environment that ethical practices can be defined, nurtured and inculcated. Cases will be
discussed to show good practices, violations and dilemmas. Team audits should also include compliance with ethical
standards and responsibility for upholding ethical values, which should be accepted by senior leadership.

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