Applying ethical principles is sometimes difficult for students

EDITOR—In raising points regarding the ethics of the provision of clinical education, Doyal suggests a framework to guide both teachers and students when interacting with patients clinically.1 On numerous occasions I have been placed in uncomfortable positions where I have felt conflict between my ethics (for example, being asked to undertake femoral arterial blood gas analysis on a comatose elderly patient without any consent having been obtained from relatives (I refused)) and my natural desire to acquire clinical skills.

Students walk this ethical tightrope every day; to refuse to do something or to object one has to tread carefully. It is often the same clinicians who put the student in this difficult position who are assessing him or her for the final grade on the clinical attachment. The move towards continuous assessment rather than …