Students whose behaviour causes concern: Ethical perspective

doi:10.1136/bmj.a2882

Published 29 December 2008, doi:10.1136/bmj.a2882
Cite this as: BMJ 2008;337:a2882

Analysis

Ethical Debate

Students whose behaviour causes concern: Ethical perspective

Deborah Bowman, senior lecturer in medical ethics and law

¹ Centre for Medical and Healthcare Education, St George’s, University of London, London SW17 0RE

dbowman@sgul.ac.uk

What should you do when you see a fellow student behaving inappropriately?After a group of students wrote to the BMJ about their experienceduring an elective (doi:10.1136/bmj.a2874), we sought the opinionsof an ethicist, a dean (doi:10.1136/bmj.a2884), a GMC representative(doi:10.1136/bmj.a2876), and a lecturer from an African university(doi:10.1136/bmj.a2875)

The first 150 words of the full text of this article appear below.

This account captures well the contrast between defining standardsof behaviour and navigating effective implementation of thosestandards. Four issues arise. Firstly, even when standards aredefined, application of those standards is a moral enterprisethat can be confusing and frustrating. Secondly, cultural relativismmay be seductive when working overseas. Thirdly, students haveto discharge significant responsibilities in a system wherepower imbalance and complex role delineation prevail. Finally,the question of who owns a problem is a bar to effective resolution.

Were the authors correct to identify this student’s behaviouras unacceptable? Yes. Although matters of ethical behaviourare redolent with uncertainty, the student was acting improperly.The authors cite guidance from the General Medical Council whichdescribes behaviour expected from medical students.¹ They mightalso have noted that, under domestic law, the student committedassault(s). But what of the location—should we acknowledgethat norms differ in societies? Ethicists . . . [Full text of this article]

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