Clinical ethics revisited

A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems.

Teaching old dogs new tricks--a personal perspective on a decade of efforts by a clinical ethics committee to promote awareness of medical ethics

To incorporate medical ethics into clinical practice, it must first be understood and valued by health care professionals. The recognition of this principle led to an expanding and continuing educational effort by the ethics committee of the Vancouver General Hospital. This paper reviews this venture, including some pitfalls and failures, as well as successes. Although we began with consultants, it quickly became apparent that education in medical ethics must reach all health care professionals--and medical students as well. Our greatest successes came in the formative years of a medical career (i.e., in medical school and residency training programmes), but other efforts were not wasted, particularly among nurses and other health care professionals. Although this is a personal review of the experience in one institution, the lessons learnt in Vancouver are applicable to the further development of medical ethics in the UK.

A curriculum for teaching clinical ethics in neonatal-perinatal medicine

Ethical thought plays a role in clinical decision-making, especially in fields such as neonatal-perinatal medicine. There is limited information, however, on the best way to teach ethics to postgraduate medical trainees in this subspeciality. This article describes the development, implementation, and evolution of a structured curriculum in ethics for a program in neonatal-perinatal medicine. The curriculum is facilitated by a specialist in ethics and based on hypothetical case scenarios, which are discussed using a framework that highlights the ethical values promoted or neglected in each decision option. Formal evaluation of the program has been impossible, but informal reviews indicate that there is a high degree of satisfaction.