Journal of medical ethics, I976, 2, 51

Editorial

Interdisciplines At a time of growing criticism of overspecialization in those disciplines whose findings affect human wellbeing it is hardly surprising that interdisciplinary discussion on moral issues has become fashionable. From its inception this journal has followed that fashion, though not, we hope, blindly. The purpose of bringing disciplines together to consider a problem is twofold: to do justice to its complexity and to provide a wide-ranging set of criteria for reaching a solution. But the pleasure of the dialogue across disciplines may itself be a snare, providing a false feeling of achievement. No problem - whether medico-moral, bio-ethical, or medico-legal - is solved merely by being described as such, as though the insertion of the hyphen itself brings salvation! Who, indeed, would ever imagine that it would be? Yet an illusion of 'consensus' is easily fostered when academics congregate with those of other disciplines. In a lusty critique of the conferencing of 'ethical bother boys' John S Bradshaw has suggested that such discussions are merely an aspect of late twentieth century medicine's 'institutionalized mental masturbation' (British Medical Journal, 27 March, p 767). The phrase has entertainment value (shades of Illich ?), but it also presents a serious challenge. It is all too easy to obscure the real issues facing a society by concentrating only on those topics the experts take delight in discussing. There are two ways of guarding against this danger and both of them are to some extent exemplified in articles in this issue. First it is necessary to be continuously questioning and refining the terms of the debate, so that genuinely new ways of tackling the problems can emerge. Ian Thompson's article on the theoretical background of medical ethics represents a move in this direction. Secondly, it is necessary to take the discussion out of the academic cloister and professional enclave. If medical ethics is to be about the problems which trouble and frustrate people then patient participation and public participation are essential. These are not easy to organize in a disciplined way and they raise problems of competence to take decisions and of appropriate channels of communication. (M De Wachter's descriptions of patient participation in interdisciplinary teams illustrate some of these.) But unless some attempts are made then our hope must surely be founded on hyphens and what we

have created is merely an interdiscipline, a new sport in the academic calendar.

Basic Medical Education In 1973 the General Medical Council asked the Department of Medical Education in Dundee (now the Centre for Medical Education) to collect and analyse information about basic medical education in all the schools in the United Kingdom. Curricula and teaching methods are being reshaped in many schools and many of these changes have resulted from the Council's recommendations of I967 which encouraged medical schools to innovate and experiment. The reason for undertaking the survey was to discover what is happening in the schools not only what curricular changes have been introduced or are being planned - but also, the difficulties and constraints facing the schools in the pursuit of their objectives. It is hoped that the information obtained will be useful both to those engaged in planning medical education in the schools and to the Council. The survey is being conducted by means of structured questionnaires backed up by personal visits from a member of the survey team. One such questionnaire deals with medical ethics. The Council's 'Recommendations as to basic medical education' (I967) suggested that certain topics not then generally taught in undergraduate courses should be included in the medical curriculum. Medical ethics is one of the nine such topics. The purpose of the questionnaire is to ascertain how far the schools have been able to implement the recommendations with respect to the topic and to find out the nature of any difficulties schools have encountered teaching it. Questions are asked as to: i) whether medical ethics is included in the medical course and if not whether there are plans to introduce it; 2) how much time is devoted to the teaching and in what year or years of the course is it taught ? 3) how is the teaching assessed ? 4) the aims and objectives of the course; 5) the use and importance placed on different teaching methods; 6) the staff responsible for teaching the topic; 7) the recent changes and planned future changes in the teaching of the topic; 8) problems related to the teaching of the subject; 9) special features of the course regarded as particularly valuable.

Editorial: Basic medical education.

Journal of medical ethics, I976, 2, 51 Editorial Interdisciplines At a time of growing criticism of overspecialization in those disciplines whose fi...
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