Selected Educational, Scholarly and Outreach Activities in Medical Ethics

This page contains information about our:

- Under-Graduate Medical Education in Medical Ethics
- Post-Graduate and Attending/Staff Education in Medical Ethics

Under-Graduate Medical Education in Medical Ethics

 Medical Ethics, Medicine Patient Society II                                           

A 6 week survey course in medical ethics required of all Cornell Medical Students. Topics include: Medical Ethics in the 20th Century: An Historical Overview; Capacity, Competence, Informed Consent and Refusal; Clinical Pragmatism as a Method of Moral Problem-Solving for Medicine;  Decisions at the End of Life: Issues in the Hospital; Ethics in Reproductive Medicine; The Medical Marketplace: Access and Managed Care and Ethics in Pediatrics. This course mobilizes approximately 25 faculty members and hospital staff,  and thus also constitutes an on-going in-service experience for tutors as well as students. 

Medicine Patient Society III                                                                                         

A Required Clerkship Designed to Promote Self-Reflective Practice and Develop Competencies in Clinical Ethics and End-of - Life Care. In response to the call for improved medical education about palliative care, the Weill Medical College of Cornell University designed Medicine, Patients, and Society III, a mandatory clerkship in the new curriculum to promote self-reflective practice and improve competencies in end-of-life care. This two-week course is notable for having students engage in what the anthropologist Renée Fox called, "participant observation."   To help students develop their humanistic skills we have asked them to rotate on a clinical service at the Cornell campus of New York Presbyterian Hospital without having direct patient care responsibilities. They are required to keep a journal in which they note how care is given and received, observe contextual factors which influence the clinical dynamic, and reflect upon their own responses.  Our goal in using this pedagogical strategy is to promote self-reflective practice. We believe that the cultivation of these observational and reflective skills is an essential ingredient in the promotion of professionalism and ethical practice. Course objectives include identifying psychosocial and contextual factors that influence care, ethical and legal issues at the end of life, and principles of pain and symptom management.  Students are expected to demonstrate the ability to apply ethical norms to patient care, describe methods of pain and symptom management, communicate in an effective and humanistic manner, and articulate models of patient advocacy.  Attitudinal goals include fostering professionalism in the care of patients, appreciating the importance of respecting cultural diversity, and assuming the responsibility for developing competency in these areas.  To develop their technical skills in pain and symptom management, students participate in palliative care rounds at Memorial Sloan-Kettering Cancer Center, attend case management problem solving seminars in palliative care, and make a site visit to observe hospice care.  Students attend additional seminar sessions to discuss their observations in patient care with a multidisciplinary faculty with expertise in palliative care and clinical ethics.  These instructors are from the departments of  medicine, neurology, psychiatry, pediatrics, and pastoral care.  Students are evaluated on the basis of their seminar participation, written journal, and a 5-7 page paper in which they identify an ethical problem and formulate a solution which promotes patient advocacy.  Preliminary evaluation of this clerkship shows that students report increased confidence in their palliative care skills and a heightened awareness of their ethical obligation to provide humane end-of-life care.

Post-Graduate and Attending/Staff Education in Medical Ethics

Clinical Ethics Education

Intramural Educational Programs and Ethics Rounds conducted on the following services as NYPH-Weill Cornell Director of  Medical Ethics since inception of program in 1994: Medicine; Anesthesiology;  Dentistry and Oral and Maxillofacial Surgery ; Emergency Department ; Neurology; Nursing; Ophthalmology; Orthopedics; Pediatrics (General, PACU and NICU); Psychiatry; Public Health; Social Work; Surgery; and Urology. These programs continue on a regular basis and often center on a discussion of a case that is under active consultation.

Monthly Ethics Committee Meetings

These sessions review ethics case consultations as well as provide continuing post-graduate education in clincial ethics. Topics most often center on issues related to end-of-life care and the care of the dying.

Optional and Tutorial Courses

 Medical students and residents have done tutorial work in medical ethics which has resulted in scholarly publications. For example, see paper by Fins and Nilson below published in Academic Medicine describing a course in medical ethics and palliative care offered as an elective to house staff.