Intended for healthcare professionals

Rapid response to:

Education And Debate

Education and debateShared ethical principles for everybody in health care: a working draft from the Tavistock GroupIntroductionA shared statement of ethical principles for those who shape and give health care

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7178.248 (Published 23 January 1999) Cite this as: BMJ 1999;318:248

Rapid Response:

Shared ethical principles: catch them early

When physicians, nurses, health care executives, academics,
ethicists, jurists, economists, philanthropists and journalists from
different countries brainstormed to present a draft of a set of
comprehensive ethical principles to guide all those working in health care
and to engender a sense of togetherness and co-operation within the health
care systems (1) they set in motion a draft that could withstand cultural
bariers and conflicts of interests, proving also that ethics could not be
situational.

Today clinical research and powerful new medical techniques have
driven all parts of the medical profession to face fundamental ethical
problems which concern the law, the attitudes of the public and the rights
of the patients as well. Thomas Percival's pioneering work, "Medical
Ethics", came in the midst of a crisis of values and conflicting voices.
It was only in 1858 that the General Medical Council (GMC) was set up
following the passing of the Medical Act. The Law is not an aim to achieve
but below which we should not fall. If the law keeps too firm a rein on a
liberalising society, society will amend the law. In the final analysis
ethical decisions should be left to every man's own conscience - however
uninformed, elastic or asleep it may be (2).

Politicians are not too interested in medical ethics unless there is
a public outcry about some medical misconduct. Therefore changes should be
made in the educational process in medical institutions and in
professional groups so that the students can be trained to provide the
future moral and scientific leadership in society. In 1965 the late Mr.
Capper how little had been done to equip medical students to face problems
in medical practice. But not until 1967 did the GMC show any concern for
the inclusion in the curriculum of more specific teachings in medical
ethics. In the academic field there are an inadequate number of people who
are qualified by outlook and training to give the necessary teaching, and
there is a great danger that it may be taken over by sociologists (3).
Librarians also feel that books on medical ethics are rarely borrowed and
some libraries have a very poor collection of books on ethics.

The Tavistock Group has now got the wheels moving - fast and
forwards, I'm sure. Health care is a fundamental right, customised and
integrated for the improvement of quality of life. It could be included as
a mandatory component of medical curricula. Here's the rule on the road to
medical education: start early, drive slowly, reach safely.

References:

1. Shared ethical principles for everybody in health care: a working
draft from the Tavistock Group. BMJ. 1999; 318: 248-51

2. Jackson DM. Professional ehics: who makes the rules? CMF (UK)
Publications; 1972

3. Crouch M. Imparting ethics to medical students. CMF (UK)
Publications, 1977

Competing interests: No competing interests

23 January 1999
Tom Oommen
Deputy Exec. Editor, BMJ (South Asia Ed.)
Kasturba Medical College, Manipal , India