Doctors' role in medical ethics
Editor - The role that doctors should play in medical ethics is not, as is often thought, one of either total disinterestedness, merely patching individuals up and sending them back into a meaningless void, nor is it a position at the coal face of ethical investigation, cutting out new ways of "doing right." Rather, the attitude that doctors have to basic science illustrates how we should learn and apply ethical considerations to our practice.
We rely on scientists to tell us how the physical world is; we have faith in their methodology and apply their principles. The most rigorous science is done by nonclinicians; clinical science is the application and extrapolation of their initial work. True to this, good doctors change their practice to fit new paradigms, applying principles that they have not This should be true of our ethical thinking. I am not arguing that we mindlessly adhere to the values of others: ethics teaching should not be merely a summary of the current state of law but includes decision making and criteria for ethical validity, enabling it to become a field that we understand and appreciate. We should, however, embrace the fact that there are those (philosophers and lawyers) better qualified than us to make dispassionate, meaningful ethical decisions and they, not doctors, should be directing the behaviour of our profession. It is right that our ethical considerations become enshrined as legal obligations-professional, patient oriented an encouragement for good doctors and a cudgel with which to beat bad ones.
The science example is extreme. The principle remains true, however, that there are those whom we can trust to provide foundational thinking and whose work we can apply to medicine. We should not fear that by giving nonmedics authority to govern our behaviour that we are losing control of our field, rather we should treasure their skills as applied to ours.
Andrew Robson, fifth year medical student, Oxford University Medical School
Email: doobriebobbins@hotmail.com
studentBMJ 2001;09:261-304 August ISSN 0966-6494
