Physician ethics and the continuum of lifelong learning

Abstract

Formal instruction in ethical analysis and decision making has become an integral component of both undergraduate and graduate medical education. This inclusion has been made because of the recognition of an increasing complexity of medical science and technology in an increasingly pluralistic and diverse society. Despite the fact that most physicians in practice today have had little or no formal ethics education, there is virtually no regular inclusion of ethics in programs of continuing medical education. This neglect of ongoing personal and professional development in ethical analysis and reflection is all the more significant because of the day-to-day encounters with these issues and dilemmas that characterize modern medical practice. Further, the “hidden curriculum” embedded in the culture of medicine may be more significant in the education and formation of young physicians than any formal ethics education. This hidden curriculum is the lived practice of medicine. This paper reviews the need for a recognition of the centrality of ethics education in the lifelong learning of physicians because of the moral nature of medical practice, the tradition of ethics in medicine, the expectations of patients and families, and physician obligations to the profession itself.