Why Ethics?

Ryan, MD/MA Bioethics Student

I’ve been asked this question by all sorts of people since I joined this program.  It’s always phrased a little differently, but the core question is the same: why ethics?

Few people know you can get a Master’s degree in Bioethics at LLU.  Even fewer know that you can get it tuition-free in one year sandwiched conveniently between 3rd and 4th years of medical school. But medical school is long enough already.  Why would I postpone medical practice yet another year?  Well, six hours of class per week is pretty nice…but it’s about much more than that.

I think doing the right thing is important, but I’m not content just trusting my gut.  The Bible, an incredible collection of spiritual and theological ideas, isn’t exactly a moral guidebook for the health professions. Most of us took some introductory philosophy class in high school or college (I didn’t). From where else can we get our understanding of what is right?  Most important to us right now is clinical ethics.  There are plenty of ethical guidelines published for professionals to use, but where do these guidelines come from? What if those guidelines don’t have it quite right? Can I defend my actions against a legal system whose members have studied ethical theory?

Most medical students dread the Ethics portion of our curriculum. I’m still undecided about whether that’s a problem of content or presentation. I’m leaning towards content. Most students I hear complain that the information is dry and boring. It certainly doesn’t help (from the students’ perspective) that 3rd year ethics sessions are at least 3 hours long. Most students see that as a good, legitimate reason to duck out of surgery, clinic, or rounds on whatever service they happen to be on, but it’s difficult to keep the focus on something that already seems so irrelevant to clinical education. I see it as completely relevant to clinical education. In fact, I see ethics as foundational.

I hope I don’t sound like I’m petty and defensive about my own program. Clearly I chose to spend an entire year focusing on biomedical ethics because of the value I see in it. I don’t advise every medical student to get a Master’s in Bioethics, but I do wish it was seen as more valuable. Perhaps my contributions to this blog will make that case, and perhaps it will help people not need a Master’s in Bioethics.

I grew up hearing that there are three basic motivations for action: fear of punishment, hope of reward, and because it’s the right thing to do. So much of the practice and governance of medicine involves penalties and incentives rather than intrinsic motivation, and I don’t want to live my life weighing a fine against an incentive payment. I think I’ll stick to the third motivation: because it’s right.  I think it’s important to not only know what the right thing to do is, but to know why I know it’s the right thing to do.

That’s why Ethics.

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