MEDEV

School of Medical Sciences Education Development

Introduction

The year long ETHICS project aimed to promote existing examples of good practice in ethics teaching and learning by drawing on the extensive combined knowledge and experience of its subject communities. The project placed a special emphasis on the teaching of professional ethics to students whose primary academic focus lies outside philosophy and religious studies.

Our findings have revealed that ethics teaching and learning is an area which is changing so rapidly, and in response to such a plethora of external forces, that there is a growing need for support and development of the learning environment.

The partner subject centres are now looking to integrate the resources produced by the project into a longer term strategy, addressing the needs of ethics learning and teaching across the curriculum.

Medicine benchmark statement includes the following:

Graduates should be prepared to approach their medical practice:

• Understanding and accepting their professional, ethical and legal responsibilities.

Graduates need to apply ethical and legal knowledge to their practice, particularly in:

• Applying the principles of confidentiality, consent, honesty and integrity.
• Being aware and complying with legal and professional responsibilities, particularly with respect to death and dying; drug prescribing; mental health; physical and sexual abuse of children and adults; abortion; reporting unsatisfactory and/or inappropriate performance.
• Considering the rights of patients.

Who needs ethics?

The requirement to teach ethics is on the increase throughout higher education and the majority of QAA Benchmarking Statements now make some reference to ethical issues or concerns.

Accordingly, many departments whose main academic interests lie elsewhere are making room within their curricula for an introduction to the moral issues germane to their area of expertise. And, of course, this has been the case for some time for the disciplines covered by LTSN-01. See the examples from the medicine benchmarking statement below.

Multiprofessional frameworks

A further reason for paying attention to professional ethics is that many graduates from LTSN-01 constituent subject areas may find work within teams drawn from a range of different professions when they leave university and all will certainly have contact with other such professionals. Accordingly, they will need to be able to discuss moral issues competently and constructively with a diverse range of people.

In some cases they will be asked to address the concerns not only of fellow professionals but of members of the public. Conflicting professional values can only serve to undermine public faith in professional standards, so an effective learning and teaching strategy must seek to present moral issues in a way that anticipates and fosters dialogue between different professions and between professions and the public. It will therefore be increasingly important for teachers of ethics to produce learning and teaching outcomes on three levels:

Subject-specific: students will need to understand:

• The moral issues that arise most frequently within medicine, dentistry and veterinary medicine.

• The range of perspectives to be expected from health care professionals on these issues.
• The range of perspectives to be expected from key stakeholders/ service users on these issues.

Interprofessional students will need to understand the perspectives of people from professionally related subject areas on issues of shared moral significance. Public students will need to understand the perspectives of private individuals and relevant social groups on issues of public concern and interest.

Fulfilling these objectives is a tall order and it is unlikely that any subject area will be able to meet the challenge on its own.

Workshops

In November 2003 the ETHICS Project offered twinned workshops at Birkbeck College, London and King’s Manor, York. Each day was structured around short presentations followed by facilitated small group discussion and had two main themes, the first of which focussed on the interdisciplinarity of professional ethics learning and teaching. While events bringing together ethicists from related fields such as healthcare or bioscience are not uncommon, the ETHICS Project’s inclusion of six subject centres, between them serving the needs of at least 56 separate disciplines, give it a much wider base on which to draw. Many delegates expressed an appreciation of the opportunity to meet ethics teachers from a wide range of disciplines and it was instructive to note how many areas of common interest and concern were identified.

The second theme reflected the direct and immediate relationship between the teaching of professional ethics in higher education and its application in real life situations. The workshops juxtaposed presentations on learning and teaching initiatives with contributions from those involved with Research Ethics Committees and Clinical Ethics Committees to present a broad perspective on the challenges facing those charged with the task of helping students acquire the knowledge and skills they need to function within the rapidly evolving moral framework of professional working practice.

Both days were productive in terms of networking and interdisciplinary collaboration. The presentations were well received, stimulating lots of lively discussion. A hardcopy guide, based on the issues and concerns identified at the workshops will be available in the spring of 2004. A report on the workshops is available at the ETHICS Project website.

Educational resources

The learning and teaching resources generated by the ETHICS Project will be disseminated—largely through its web pages which will offer information on issues such as assessment, consent and confidentiality.

It will also provide information on the use of case studies. In addition to a general discussion and useful links there will be a database of examples that have already been used successfully in learning and teaching. These case studies or Contextualised Scenarios are working examples of applied ethical problems used to highlight relevant ethical principles.

It is hoped that the database will provide a useful resource not only for new teachers of ethics looking for ideas on course development, but also for experienced ethicists for whom it will provide a ‘snapshot’ of current teaching and learning priorities. At the moment the database is drawn from the partner subject areas but it is hoped that it can be extended to include examples from across the curriculum. If you have used case studies in your own teaching please contact the subject centre for Philosophical and Religious Studies (see contact details below).

The Project’s objectives with regard to the development of human resources are potentially the more significant in the long term. Despite the supradisciplinarity of ethics, ethics communities remain largely subjectspecific but two workshops organised by the ETHICS Project established that there is a demand for interdisciplinary events, at which people get a chance to meet and exchange ideas with teachers of ethics from other subject areas. The Subject Centres are in a unique position to coordinate networks in areas such as ethics which are not generic and yet spans a range of otherwise unconnected subject areas. The ETHICS Project partners will therefore be keen to build on what has been learned over the last year by encouraging a broader discourse on ethics learning and teaching across the curriculum. Any future events will be publicised via its web pages.