The recent essay by Schuklenk and Smalling opposing respect for physicians’ conscientious objections to providing patients with medical services that are legally permitted in liberal democracies is based on several erroneous assumptions. Acting in this manner would have serious harmful effects on the ethos of medicine and of bioethics. A much more nuanced and balanced position is critical in order to respect physicians’ conscience with minimal damage to patients’ rights.

Introduction Outbreaks of serious communicable infectious diseases remain a major global medical problem and force healthcare workers to make hard choices with limited information, resources and time. While information regarding physicians’ opinions about such dilemmas is available, research discussing students’ opinions is more limited. Methods Medical students were surveyed about their willingness to perform medical procedures on patients with communicable diseases as students and as physicians. Students were asked about their opinions regarding the duty to treat in such cases. Results (...) 74% of respondents felt that by deciding to enter medical school they were morally obliged to treat any patient despite the risks. Students’ willingness to treat as physicians is significantly higher than their willingness to treat as students. HIV was significantly the most tolerated disease with respect to performing mouth to mouth resuscitation. Among preclinical students, we found that willingness to treat during the later years is significantly greater than during the earlier years. Among clinical students, the opposite was observed. Discussion Students’ greater willingness to treat as physicians is mostly attributed to perceptions of higher obligations as a qualified doctor. There is greater but not total willingness to perform resuscitation on patients with HIV relative to other diseases. The increased willingness of preclinical students and the decreased willingness of clinical students both emphasise the importance of patient–physician communication and ethics studies during medical school. (shrink)

Introduction Outbreaks of serious communicable infectious diseases remain a major global medical problem and force healthcare workers to make hard choices with limited information, resources and time. While information regarding physicians’ opinions about such dilemmas is available, research discussing students’ opinions is more limited. Methods Medical students were surveyed about their willingness to perform medical procedures on patients with communicable diseases as students and as physicians. Students were asked about their opinions regarding the duty to treat in such cases. Results (...) 74% of respondents felt that by deciding to enter medical school they were morally obliged to treat any patient despite the risks. Students’ willingness to treat as physicians is significantly higher than their willingness to treat as students. HIV was significantly the most tolerated disease with respect to performing mouth to mouth resuscitation. Among preclinical students, we found that willingness to treat during the later years is significantly greater than during the earlier years. Among clinical students, the opposite was observed. Discussion Students’ greater willingness to treat as physicians is mostly attributed to perceptions of higher obligations as a qualified doctor. There is greater but not total willingness to perform resuscitation on patients with HIV relative to other diseases. The increased willingness of preclinical students and the decreased willingness of clinical students both emphasise the importance of patient--physician communication and ethics studies during medical school. (shrink)

I was deeply moved and inspired by Jason Dubroff’s article1 objecting to the source of the white coat distributed to the entering medical students at his school. The article stimulated me to ponder its implications and led to some thoughtful discussions with colleagues. Here was a busy medical student who was appropriately disturbed at what he regarded as a kind of ethical failure at the very ceremony, which was meant to exemplify and emphasise the values of humanism. However, unlike many (...) of us who notice evidence of ethical insensitivity, react with a sigh or a comment, and go on with our lives without significant alteration in our normal activities, Jason initiated an investigation of the issue, researched it in his own time, and even proposed remedial actions—a remarkable, unusual and impressive course of events. His article reinforced some of my personal prejudices. To those of my colleagues who nostalgically bewail the alleged decrease in idealism in today’s entering medical students, I can point to Jason as an example of the kind of ethical sensitivity, …. (shrink)

A few years ago, a Yemenite patient came to Maimonides Hospital in Brooklyn. The friendly, diminutive gentleman apologized for visiting the clinic in the first place because, as he explained, he was a devotee of Maimonides and invariably used the medical treatments recommended by him rather than current Western medicine. But for this patient’s problem, Maimonides had prescribed garlic. The patient told his doctor that if he ingested garlic, his wife would refuse contact with him. So, having no alternative, he (...) came to our clinic for consultation and to see if there were any other appropriate treatments.Moses Maimonides was one the most important Jewish scholars of all times. A popular folk saying.. (shrink)