Are medical students being forced by their professors to act unethically? That could possibly be the case at least at some medical schools. In a study appearing in the publication
British Medical Journal about nine months ago, it was discovered that about 50% of medical students felt under pressure to act unethically. Worse, about 66% observed one of their clinical teachers acting unethically. How is this possible? Are medical schools concerned about ethics?
The medical students were studying at the prestigious University of Toronto. The students reported overhearing instructors intentionally lying to patients, asking students to perform surgical procedures they hadn’t been trained to do and other equally disturbing abuses. One case that was very troubling to students was when an instructor turned a very sick patient into a “teaching model” for four hours when the observation they needed could have been accomplished in minutes. Is it possible that medical schools are more interested in the process vs the healing outcome?
Perhaps the worst finding was that students did not feel confident talking to their instructors about ethical issues.
Naturally, when the University of Toronto medical school faculty heard the results they were quite upset, but at the same time the people who did the study felt that the results would probably be applicable to any country in the world. The researchers said the comments from the Canadian students would also be applicable to U.S. schools. The Canadian medical school system is excellent and very comparable to any American school curriculum. There is no reason to doubt the similarity of results among medical schools.
Medical Schools – What are we teaching?
There is hardly a month that goes by where we don’t witness an upsetting, even outrageous case of medical malpractice. It may be a physician working for a pharmaceutical company gouging drug costs, a “clinic” offering completely bogus treatments, unnecessary procedures, or opioid abuses. Then there is Medicaid and other insurance fraud, lying to patients, overcharging, and on and on. We often wonder where, or how, a medical professional could possibly spiral so low to become everything we always felt a physician could never be. Where does this behavior start? Apparently, it can start in medical school.
However, let’s not be naïve here. Is a physician a person or a profession? Yes, you could argue both, but ethically the same pressures to become unethical affect truck drivers and carpenters as much as politicians and physicians.
Ethical behavior is learned, and it can be taught. Unethical behavior can also be learned and it can be taught as well. Both behaviors are reinforced. A physician who opens a clinic in a poor neighborhood and gives time, energy and great compassion in helping to heal the sick is said to be an ethical person and a credit to the profession. A physician who opens a “spa” in California, doling out fake or dubious remedies to terminally ill cancer patients for exorbitant sums of money is said to be an unethical person and a stain on the profession.
The difference is training and the reinforcement of that training. But what of a medical school’s faculty that encourages unethical behavior? What of them?
Though there are medical ethics classes galore, it would seem that to many medical students it is more window dressing than serving of any purpose. The problem is that an extreme lack of ethics in medical schools may lead to dead patients. In an example such as I gave above, the physician who force feeds herbal potions to patients knowing full well they will fail, has in turn been failed by the system.
Medical school students are obviously very bright. At the same time, most are young and impressionable. It stands to reason that it may be highly useful to have outside ethics teachers teach students in language that is real-life and impactful rather than clinical, cold and simply medical.
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