Ethics in medicine

Is modern medicine, preoccupied with disease and treatment, undermining ethical concerns? Are our priorities misplaced? Are we leaning towards fame and fortune, rather than basic human disposition?

I set off for the ethical guided tour with the American Medical Association's virtual mentor (www.ama-assn.org/ama/pub/category/3040.html). The site familiarises young doctors with the law, humanities, and bioethics. Each month, the site deals with a "hot area" in medical ethics from all possible perspectives. For instance, the August 2003 issue was dedicated to problems in paediatrics. Cases are presented-one described how a specialist treated a sick child in spite of parental opposition steeped in religious dogma-and then different experts comment. A presentation shows how doctors should make decisions when parents and children are scared of a particular treatment. In Case in Health Law, you get to know about the legal footholds. The archive stores plenty of such complicated ethical dilemmas-ranging from end of life care to maternal-fetal conflict.

Run by University of Washington School of Medicine,http://eduserv.hscer.washington.edu/bioethics/toc.html is a comprehensive site offering glimpses of biomedical ethics in a clinical context. Bioethics Tool is a sort of primer, based on views from moral philosophers, aimed at familiarising doctors with the art of balancing "benefiting" with "avoiding harming" patients in critical cases. Bioethics Topics contains discussions about specific areas of conflict, which usually place doctors in acute dilemmas. For instance, Breaking Bad News will help you manoeuvre through emotional outbursts of patients and relatives if you have given a fatal prognosis. The Mistakes section will train you to confess your errors effectively without inviting patient ire. Physician-Patient Relationship gives priceless tips to win patients' trust. The site includes good links at the end.

The online journal BMC Medical Ethics (www.biomedcentral.com/bmcmedethics) showcases original research articles on the ethics of medicine in real situations, faced by doctors in different parts of the world. The debate section informs about futuristic issues-human cloning laws, DNA databanks-along with tricky things like the sedation of dying patients in intensive care. The archive will familiarise you with unforeseen problems and is backed up with in-depth analyses.

Aggressive marketing from pharmaceutical companies influences doctors' prescribing all over the world. To counter such unethical practice and to promote evidence based health care, www.nofreelunch.org was launched in 1999. The site opens with a questionnaire to make you aware how our profession is slowly becoming dependent on drug companies. Facts and Fallacies offers you links to data and research about this unfortunate trend. The website helps you to stand up for your professional ethics and confidently refuse gifts from drug companies. A section for medical students explains how to organise activities and run pledge drives against unfair drug promotion.