Ethical Practice in Clinical Medicine

Ethical Practice in Clinical Medicine

Ethical Practice in Clinical Medicine

Ethical Practice in Clinical Medicine

Synopsis

Increasingly, medical students are required to face up to ethical issues in their training and practice. At the same time, there is growing interest in philosophy courses in the ethical issues raised by medical practice. This textbook, designed primarily for students of medicine, develops the issues to a philosophical level complex enough to be satisfying to students of philosophy as well as MA students on applied ethics courses. The author advocates an approach to medical ethics which breaks out of the straitjacket of the narrow choice between utilitarian or deontological theory, and contains a valuable discussion of practical wisdom. It maintains a balance between case studies and philosophical arguments - which are developed in a historical context, and will be of interest at all levels of the medical profession.

Excerpt

The first two years of medical school are spent basically in the classroom in an academic study of the principles of medicine. Delineations are made of the structures of anatomy and organ systems. the facts of basic medical data are learned in great detail. Then comes a shock. the last two years of medical school, often called a clerkship or clerking, initiate a whole new type of learning experience. This way of learning and practicing medicine will continue on through the years of residency and specialization. It will be the basic method of on-going constant learning during the whole of the physician’s life and practice.

To many medical students the reason for the shock at moving from classroom to hospital ward is that the structures and principles so precisely learned seldom so rigidly hold in actual cases. There are constantly anomalous elements which will not neatly fit into a schemata. Recalcitrant details plague precision. This is especially frustrating to the medical student who is almost by nature a perfectionist and often something of a work-oriented maximum achiever. As a pre-medical student such an individual made very few examination mistakes, agonized over those which were made, and spent long study hours making sure that such mistakes would not in the future occur. This same pattern held during the first two years of medical school. What a surprise to find that on clinical rounds lack of certainty and fumbling about are a constant daily experience. Yet the highly educated guesswork which informs the best diagnostic and prognostic procedures yields often seemingly miraculous results. Over a number of years, and eventually over a lifetime, the skills of clinical practice are acquired and an ease and efficiency in patient cure and care is developed. the actual practice of medicine is a highly skilled art of immense . . .

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