In this article I discuss the ethical ramifications for medical ethics training of the availability of large language models (LLMs) for medical students. My focus is on the practical ethical consequences for what we should expect of medical students in terms of medical professionalism and ethical reasoning, and how this can be tested in a context where LLMs are relatively easy available. If we continue to expect ethical competences of medical professionalism of future physicians, (...) how much – if at all – should we worry that such generative AI may compromise adequate testing of medical students’ abilities in this regard? I mainly focus on assessment methods based on written assignments of the ‘student paper’ type and consider whether LLMs make it unfeasible for assessors to gauge whether output is student-generated or ‘machine-generated’ and, if so, whether this is a problem. My take on this research question unfolds in three interwoven arguments, claiming that the advent of LLMs may offer a momentum (i) to reaffirm the importance of context-sensitive interpretation and specification of ethical principles in medical ethics training, (ii) to provide more supportive circumstances to assessors to allow them to meet scoring demands entailed by the importance that is placed on medical professionalism, and (iii) to complement written assignments with verbal (group) discussion to train and test students’ skills to habitually recognize that ‘moral solutions’ can be normatively questioned and specified from various perspectives. (shrink)

It has been presumed within bioethics that the benefits and risks of treatments can be assessed independently of information disclosure to patients as part of the informed consent process. Research on placebo and nocebo effects indicates that this is not true for symptomatic treatments. The benefits and risks that patients experience from symptomatic treatments can be shaped powerfully by information about these treatments provided by clinicians. In this paper we discuss the implications of placebo and nocebo research for risk–benefit assessment (...) and informed consent. (shrink)

In Medical Ethics, the editors have developed a completely different type book, focusing upon issues not ordinarily dealt with in texts on bioethics.

This paper describes the change of emphasis that occurred in the teaching of ethics to small groups of clinical students. Although the original focus of the course was on the analysis of ethical dilemmas associated with individual patients known to the students, it soon became evident that there were, for the students themselves, more fundamental ethical dilemmas in their new role as clinical students. These included worries about how to respond when patients asked questions which their consultants had previously (...) deceived them about, worries about inflicting pain on patients, as with intravenous cannulation, and the role of the medical student in the clinical team. We emphasise the need to explore student experiences as part of the process of ethics teaching. (shrink)

I. Telling a patient: Midrash Rabba and Gersonides.--II. An ancient view on the risk of congenital disaster.--III. Overpopulation: 1300 years ago.

A compendium of various healthcare policies, guidelines, protocols and programs that concern clinical issues with ethical implications are found in Medical Ethics. The collection of policies, guidelines and procedures found in this manual are helpful in drafting and reviewing one's own institutional procedures and help policymakers develop useful mechanisms for assuring ethical treatment of patient and staff.

In this case analysis deception or lying to a dying patient is discussed within the context of different relationships: the relationship between the patient and her family doctor, the relationship between the patient and the surgeon and the relationship between the patient and her family. It is suggested that the principle of veracity is not only a core feature in the patient-doctor relationship but is also fundamentally connected with the basic element of trust between the patient and doctor. The surgeon, (...) in deceiving the patient, even at the request of her husband, betrayed her trust in violating the principle of veracity. The primary responsibility of the surgeon was towards his patient rather than her family. In lying to his patient the surgeon failed to give Mrs Fasper something she needed most: respect for her as a person. (shrink)

Medical doctors are commissioned by the migration authorities and/or border police to assist in decision making about asylum seeker’s requests for residency permits in Sweden. They are asked to: (i) assess the formal written medical opinions made by physicians in support of asylum or humanitarian narratives in the asylum process and/or (ii) to make medical assessments of persons considered for deportation. This arrangement raises questions such as: How is the decision making process carried out? How is (...) class='Hi'>medical knowledge used, and who ought to make decisions about medical evidence in the asylum process? Does this approach effect public health overall? There are longstanding concerns that medical assessments to certify whether a person is fit for transport or not, can have a direct, negative impact on persons in need of care and protection. A separate structure of doctors commissioned by the immigration authority seems to raise professional tensions, politicizes medical constructs and contributes to moral disengagement. Empirical data are used to illustrate this discussion with reference to medical issues, medical ethics, public health and legal discourses. I then reflect on key value conflicts using public health ethics theory and conclude with implications for public health ethic theory, policy and practice. (shrink)

This issue of the Journal of Medical Ethics focusses on the ethical implications of recent scientific and medical advances: for humans, for animals and for the boundary between the two. In this month’s ‘Current controversy’, Julian Savulescu and Tsutomu Sawai consider the implications of recent research to transplant human brain organoids into the brains of infant rats, arguing that such technology has the potential to enhance the cognitive capacities of animals in ways which invites questions over their (...) moral status.1 This debate will only increase in intensity as more sophisticated brain organoids begin to be introduced, in the future, even, perhaps, to primates. The ‘Feature Article’, written by Rodger et al,2 and its commentaries similarly consider the ethical duties owed to animals in the conduct of medical research and treatment, although in the context of xenotransplantation, where organs from animals (in particular, pigs) are transplanted into humans in a bid to tackle organ shortages. While Rodger et al proposes that in order to be ethically defensible, xenotransplantation should use genetic ‘disenhancement’ so as to eliminate or minimise the pain and suffering experienced by animals, the commentaries raise a number of issues with this proposal, questioning whether this requires the author to accept the morally permissibility of xenotransplantation in the first place, as well as whether disenhancement might inadvertently discourage the development of more ethical ways to tackle organ shortages. Taken together, these papers raise significant questions, not just about …. (shrink)

This paper challenges the long-standing and widely accepted view that medical ethics is nothing more than common morality applied to clinical matters. It argues against Tom Beauchamp and James Childress’s four principles; Bernard Gert, K. Danner Clouser and Charles Culver’s ten rules; and Albert Jonsen, Mark Siegler, and William Winslade’s four topics approaches to medical ethics. First, a negative argument shows that common morality does not provide an account of medical ethics and then a (...) positive argument demonstrates why the medical profession requires its own distinctive ethics. The paper also provides a way to distinguish roles and professions and an account of the distinctive duties of medical ethics. It concludes by emphasizing ways in which the uncommon morality approach to medical ethics is markedly different from the common morality approach. (shrink)

The prelims comprise: Introduction The Foundations of Altruism and Autonomy in Medical Ethics The Problem of Medical Injury and the Emergence of Safety The Ancient Practices of Malpractice Litigation What Do We Disclose Today, and What Will We Disclose in the Future? Malpractice Reform: Health Courts References.

The history of American medical ethics is a notoriously unwieldy field that encompasses an enormous amount of complex material. No single book can realistically analyze all of its dimensions in a genuinely scholarly fashion. But Robert Baker, one of the nation’s most distinguished professors in that field, has now provided the rest of us with an immensely helpful survey of one of its most important aspects: the evolution of what he terms “the formalized statements of medical morality” (...) (164). Much of Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution traces, in an almost genealogical manner, medicine’s shifting behavioral codes and ethical systems from .. (shrink)

A practical approach to ethics -- The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Treating children and young people -- Confidentiality -- Management of health records --Prescribing and administering medication.

I end with another parable, but it is also a true story. Harvey Gushing, the famous surgeon after whom the Gushing Lectures are named, made an international reputation in his allegiance to quality. He badgered his profession to a higher standard of self-effacement and railed against the debasement of clinical skills and overemphasis on research and pursuit of personal gain. We honor him to this day because those were, and remain, important points. Yet, Harvey Gushing served as a surgeon during (...) World War I and at Ypres. Although the Allied mortality was as much as 50,000 soldiers a day, not counting the wounded, Gushing refused to operate on any more than two patients each day, arguing that to do so would have lowered his standard of care for his patients a – standard that made sense in one time but that became strikingly insensitive, and I suggest even unethical, in another when confronted with a different reality. (shrink)

In this unique study, Jean-Pierre Clero examines medical ethics from a philosophical perspective. Based on the thoughts of great philosophers, he develops a theory of medical ethics that focuses on the values of intimacy.

Foundations of medical ethics and law -- Professionalism and medical ethics -- The doctor, the patient, and society -- Ethics and law at the beginning and end of life -- Healthcare commissioning and resource allocation -- Introduction to sociology and disease -- Experience of health and illness -- Organization of health care provision in the UK -- Inequalities in health and health care provision -- Epidemiology and public health -- Clinical governance.

The correlation between medical ethics and medical law, while seemingly far removed from the context of Eastern Orthodoxy, is in fact of deep theological significance and eschatological prominence and has become increasingly a matter of concern in contemporary Russia. The following study examines different modes of this correlation and their moral implications for the wider society.

Medical Ethics, Law and Communication at a Glance presents a succinct overview of these key areas of the medical curriculum. This new title aims to provide a concise summary of the three core, interlinked topics essential to resolving ethical dilemmas in medicine and avoiding medico-legal action. Divided into two sections; the first examines the ethical and legal principles underpinning each medical topic; while the second focuses on communication skills and the importance of good communication. Medical (...) Ethics, Law and Communication at a Glance offers an accessible introduction to the fundamentals of good medical practice, and will provide indispensable support for undergraduate medical students and nurses, as well as newly qualified healthcare professionals. (shrink)

Drawing from a wide range of primary historical and sociological sources, this book presents medical ethics in China from a Chinese-Western comparative perspective, and in doing so it provides a fascinating exploration of cultural differences and commonalities exhibited by China and the West in medicine and medical ethics. The book focuses on a number of key issues in medical ethics including: attitudes towards foetuses; disclosure of information by medical professionals; informed consent; professional (...) class='Hi'>medical ethics; and human rights. This careful examination not only provides insights into Chinese viewpoints, but also sheds light on the appropriate methods for comparative culture and ethical research. Through its analysis, Jing-Bao Nie seeks to put forward a theory of "transcultural bioethics", an ethical paradigm which upholds the primacy of morality whilst resisting cultural stereotypes, and appreciating the internal plurality, richness, dynamism and openness of medical ethics in any culture. Medical Ethics in China will be of particular interest to students and academics in the fields of Medical Law, Bioethics and Medical Ethics as well as Chinese/Asian Studies and Comparative (Chinese-Western) Cultural Studies. (shrink)

There is a diversity of ‘ethical practices’ within medicine as an institutionalised profession as well as a need for ethical specialists both in practice as well as in institutionalised roles. This Brief offers a social perspective on medical ethics education. It discusses a range of concepts relevant to educational theory and thus provides a basic illumination of the subject. Recent research in the sociology of medical education and the social theory of Pierre Bourdieu are covered. In the (...) end, the themes of Bourdieuan Social Theory, socio-cultural apprenticeships and the ‘characterological turn’ in medical education are draw together the context of medical ethics education. ​. (shrink)

Part 1. Foundations -- Reasoning about ethics -- Ethical theories and perspectives -- Three core concepts in medical ethics : best interests, autonomy and rights -- An introduction to law -- Doctors and patients : relationships and responsiblities -- Part 2. Core topics -- Consent -- Capacity -- Mental health -- Confidentiality -- Resource allocation -- Children and young people -- Disability and disease -- Reproductive medicine -- End of life -- Organ transplantation -- Research -- Part (...) 3. Extensions -- Neuroethics -- Genethics -- Information ethics -- Public health ethics. (shrink)

This book is a comprehensive survey and a sustained treatment of the major topics in contemporary medical ethics from within the Roman Catholic tradition. It brings together perspectives from philosophy, theology, medicine, and law to explore the traditions that undergird Catholic medical ethics. The authors of this book are, respectively, a philosopher, theologian, physician, and attorney. Their commitment to the Roman Catholic tradition provides the foundational principles for addressing a wide range of issues in contemporary (...) class='Hi'>medical ethics. These topics include abortion, reproduction, cloning to produce children, cloning for biomedical research, embryonic stem cell use, genetics as screening, testing, therapy, enhancement, engineering, specific special relations such as maternal/fetal, physician/patient, mentally ill/caretakers, health care, and end of life issues. Furthermore, the book elaborates on the ways in which the authors' professions and disciplines act in service to medicine as an instrument for real human flourishing. Medical Ethics in the Catholic Tradition is for the physician who would like to know more about the philosophical/theological/legal traditions that undergird the Catholic position. It is for the attorney who would like to know more about the philosophical/theological/medical traditions that undergird the Catholic position. Similarly, the philosopher or theologian can find here the appropriate information to understand how science and law contribute to the development of the Catholic position on major issues in medical ethics"-- Provided by publisher. (shrink)