Ethics and professionalism

From Oncology for Medical Students
Ideal oncology curriculum > Ethics and professionalism

Objective 7

At graduation, the student should be able to:

a) demonstrate an understanding of the effects on health professionals of caring for patients with cancer and of the ways in which the stresses of this work can be managed appropriately
b) discuss the bioethics of issues such as access, equity and resource allocation, as well as medical care at the end of life
c) identify the key medico-legal issues in diagnosis, screening/early detection, management, evidence-based guidelines, defensive medicine, commutative justice, distributive justice, social justice, physician-assisted suicide, euthanasia
d) discuss principles, elements and role of informed consent in patient decision making.

Prerequisite knowledge

  • Understanding of broad medico-legal principles, patient consent, autonomy and privacy

Representative questions that suggest the required depth of knowledge

1. You are a GP in a five-doctor practice. A colleague is chronically unwell and a number of patient complaints have called into question his competence. What do you need to consider in resolving this problem?

Essential in answer:

  • Direct approach to colleague
  • Medical defence aspects
  • “Sick doctor” counselling
  • Defining clear outcomes-based plan

2. Why is eliciting a patient’s agreement to proceed with cancer treatment a complex problem?

Essential in answer:

  • Differences in knowledge base
  • Language:
– English as a second language, or inability to understand English at all;
– Lay usage v medical jargon
  • Necessity to allocate sufficient time
  • Repeat visits
  • Oral v written v tape/video
  • Problems in defining risk-benefit and probability of benefit