Ethical, professional, and legal obligations in clinical practice: a series of discussion topics for postgraduate medical education. Introduction and topic 1: informed consent.

Introduction Postgraduate education in ethical, professional, and legal obligations of clinical practice has been neglected with the result that the training of junior doctors in these matters is intermittent and incomplete. In order to remedy this failure, short sessions were held in our hospital every three weeks or so over a six month period during which a range of important topics was discussed. The sessions were informal, learner based, and problem based. The sessions were prepared with reference to readily available non-academic publications. While this series was planned for a general surgical unit, a similar series could easily be prepared for a diVerent specialty. Never before has the conduct of doctors been the object of such intense scrutiny by the media and the public, and no branch of medicine is immune from censure. Ethical standards are incorporated into the “Duties and responsibilities of doctors” produced by the General Medical Council (GMC), which form the core of our professional obligations. These are not statutory legal obligations as such but they do carry a good deal of weight in law since the GMC is itself a statutory body. In certain instances statute law is relevant; in many other instances common law and case law (precedent) guide medical practice. Although medical schools are obliged by the GMC to educate medical students in good ethical, professional and legal practice, many junior doctors lack confidence in these subjects. A Medline search found no useful literature on postgraduate education in ethical, professional, or legal matters. As a specialist registrar working in a busy surgical unit at a medium sized district general hospital I felt it would be worthwhile to facilitate short sessions dealing with these subjects as part of the unit educational commitment. These informal discussions were geared towards trainees and included cases typical of those with which the unit dealt. The sessions took place every three weeks or so and soon gave rise to much lively debate among all the unit staV from house oYcer to consultant. Throughout the series we kept to the basics of good clinical practice. The sessions were not meant to be a formal ethics and law course. Their purpose was to address common problems in general surgery. The literature to which I refer is mostly readily available from the GMC and the medical defence organisations. The very lack of academic references is a bonus; any motivated practitioner can devise a similar programme for his/her own specialty with reference only to day-to-day experience and readily available non-academic literature. The following discussion topic is based on one of our sessions; a further four discussion topics will be published in the next four issues of this journal.