Is it just semantics? Medical students and their ‘first patients’

Journal of Medical Ethics 45 (6):411-414 (2019)
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Abstract

There have been multiple factors involved in the decline of the anatomy course’s central role in medical education over the last century. The course has undergone a multitude of changes, in large part due to the rise in technology and cultural shifts away from physical dissection. This paper argues that, as the desire of medical schools to introduce clinical experiences earlier in the curriculum increased, anatomy courses began implementing changes that would align themselves with the shifting culture towards incorporating humanistic values early on in the medical curriculum. One of these changes, argued as a product of this shift, included calling a cadaver a ‘patient’ and introducing the cadaver as a student’s ‘first patient’. This change has been seen in different universities and textbooks. This paper argues that the use of the words ‘patient’ to describe the cadaver in order to promote principled habits in medical students may in fact create an environment that does the opposite. By equating an environment in which the subject of dissection is lifeless and incapable of participation, and the space is discouraging of emotions and conducive to untested coping mechanisms to the clinical environment through using the word ‘patient’, values like detached concern, a controversial practice in medicine, can be implicitly encouraged. An ethical analysis of the use of the word ’patient’ to describe the cadaver shows that this practice can promote unethical habits in students and that changing this aspect of anatomy lab culture could improve ethical dispositions of future physicians.

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Citations of this work

Use of cadavers to train surgeons: what are the ethical issues?Hannah James - 2020 - Journal of Medical Ethics 46 (7):470-471.
The ethics of semantics in medicine.David Shaw, Alex Manara & Anne Laure Dalle Ave - 2022 - Journal of Medical Ethics 48 (12):1026-1031.
Clinical ethics and the duty of care.John McMillan - 2019 - Journal of Medical Ethics 45 (6):355-356.

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