Can a Medical School Afford NOT to Have Medical Ethics?
Evidently, at least one major medical school things so. And to boot, their Chancellor, President and Board of Trustees appears to think that they can not only afford to live without a medical ethics department but to actively do away with their current one.
The Health Science Center at the University of Tennessee is considering a series of cutbacks that includes the excising of the Department of Human Values and Ethics at that university. When searching for places that the budget could be trimmed, clearly ethics was something that was expendable. Yet, clearly these administrators did not think about how much money ethicists actually save a university in terms of real costs--ethics consultations prevent real and horrible conflicts from happening at university hospitals around the country every day that cost hospitals millions of dollars. Having ethicists on staff mean that problems with research and in the clinical setting get solved, new policies get made, and most ethicists do this work without additional pay--while they are teaching classes and performing other essential services to the university.
It is odd that this institution would choose this cut at this time while most other medical schools are racing to add medical ethics to their curriculum, to their rosters of centers and departments. Clearly it's not just window dressing either--these departments and faculty members do real work for universities and medical schools---if I toot the horn of my colleagues!
So, let's ask the critical question again: can UT or any other medical school afford not to have medical ethics? I think the answer is a clear: I think not.
Summer Johnson, PhD
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This is an interesting development, though not unprecedented. For instance, when I left Imperial College London in 2006, within 6 months it had closed its ethics unit. As it is a requirement of the professional accreditation body that students of medicine be taught, and assessed, in medical ethics and law, the teaching was pared right back and delivered by a clinician in her spare time (she's a great teacher, with a postgraduate qualification in ethics, but no other major element of the curriculum is delivered on such an ad hoc basis).
Let's look at this question again: first of all, is cost saving really the best argument for ethics centres and ethics teaching? Second, have we done enough to demonstrate the impact of ethics teaching and ethics consultation? Third, have we become victims of our own success (we've taught the subject so well to our clinical peers that they can manage without us? or think they can?) Fourth, and related, have we become so domesticated in medical schools that actually we're not enough like grit in the oyster, challenging and questioning rather than facilitating and smoothing over? And fifth are we mistaking what is in the patient's interest for what is in our own? If we cannot answer the first four questions honestly and well, then maybe the fifth question has to be answered in the affirmative, and if so, is closing an ethics centre or two - or more - really a disaster for anyone other than the ethicists?
I realise that there is probably much more to this story than meets the eye, but having fought (and won, and lost) a few battles over this issue in the last few years, I think the bioethics community needs a little introspection on these issues.
- by Richard Ashcroft on Mar 2, 2009 at 9:09 AM | link
The Ethics Department at UT's medical school was what made it special. At my institution, we have hundreds of rising seniors headed to medical school. I'll now have to advice them against UT because I believe ethics is an essential component of a medical education.
- by Andrea Kalfoglou on Mar 2, 2009 at 10:04 AM | link
This is a big trouble for Harvard but we will not judge is at what we read in the materials but we should be more open minded to understand what really is the issue.
- by PreMedical University on Mar 4, 2009 at 1:38 AM | link