Conscience Sensitive Approach to Ethics and Teaching Caring Attitudes

Medicine is a moral enterprise, and medical educators have a primary moral and professional obligation to students to teach, evaluate and nurture this aspect of the curriculum. We assume our students enter medical school as persons of conscience, and that our job as teachers, in addition to helping them master facts, critical and clinical thinking and skills, is to promote their development into professionals of conscience, and eventually, virtuous physicians. Thoughtful students quickly grasp the fact that what we can do in medicine usually outpaces the consensus of what we ought to do, and one of the earliest questions these students ask is how they should go about honoring their individual moral selves in the face of patients, peers, or teachers who profess divergent values, or request services that jar the young professional’s sense of moral ought-ness. Medical educators readily recognize the moral requirement to teach ethics, but struggle to engage effectively the moral reasoning of students who are inundated with basic science courses and clinical skills training (Self and Baldwin, 1994). Students appreciate hearing case stories, and recognize in the practice of case-based ethical dilemma resolution similarity to other medical problem solving processes, but are impatient with philosophical theory. Most students at our institution were biology or chemistry majors, and few have taken any courses in literature, philosophy, religion, ethics, or other humanities.