Editorial / Éditorial
Bioethics for cliniciansPeter A. Singer, MD, MPH, FRCPC
|  Order now! |
|
Canadian Medical Association Journal 1996; 155: 189-190
[résumé] |
Dr. Singer's work is supported by the National Health Research and Development Program through a National Health Research Scholar award. The University of Toronto Joint Centre for Bioethics is a partnership among the University of Toronto, the Clarke Institute of Psychiatry, The Hospital for Sick Children, Mount Sinai Hospital and The Toronto Hospital, Toronto, Ont., and the Sunnybrook Health Science Centre, North York, Ont.
© 1996 Canadian Medical Association (text and abstract/résumé)
Almost 20 years ago Siegler emphasized that the goal of teaching bioethics is to improve the quality of patient care by identifying, analysing and attempting to resolve the ethical problems that arise in the practice of clinical medicine.[1,2] Today, every medical school in Canada incorporates bioethics into its curriculum, and both the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada require teaching of bioethics as a condition of accrediting residency programs. However, the extent to which education in bioethics informs and improves the clinician's work is unclear.
In this issue (see pages 177 to 180 [full text / résumé]) appears the first article in a 14-part monthly series on bioethics for clinicians. This series is intended to elucidate key concepts in bioethics and to help clinicians to integrate bioethical knowledge into daily practice. In educational terms, the goal is to support performance: what clinicians actually do.
Professional performance with respect to bioethical matters depends on many factors, including the clinician's values, beliefs, knowledge of ethical and legal constructs, ability to recognize and analyse ethical problems, and interpersonal and communications skills. Although the Bioethics for Clinicians series cannot address every aspect of bioethics in medical practice, the authors hope that it will provide a helpful starting point for clinicians and complement educational initiatives such as the Bioethics Project of the Royal College of Physicians and Surgeons of Canada, which is developing model bioethics curricula for Canadian postgraduate programs in medicine, surgery, psychiatry, obstetrics and gynecology, and the PEDETHNET initiative, which has developed a postgraduate bioethics curriculum in pediatrics.
The Bioethics for Clinicians series has been written with the practising physician in mind but should also be useful to educators teaching bioethics in medical schools, residency programs and continuing medical education. It may also be of use to nurses, social workers, physiotherapists, occupational therapists and other health care providers.
This series will address topics selected for their clinical relevance: consent, capacity, disclosure, voluntariness, substitute decision making, advance care planning, truth telling, confidentiality, ethical issues in genetics, fetal-maternal dilemmas, child health care ethics, research ethics, euthanasia, and resource allocation. At the conclusion of the series, the articles will be published as a monograph by the CMA.
Each article is written by a team of scholars in medicine, ethics and law. This interdisciplinary approach will help to ensure that concepts are described faithfully with respect to their empirical context in medicine and with an understanding of their theoretic roots in ethics and law.
Each article will begin with one or more clinical cases highlighting the issue under discussion and will end with suggested approaches to these cases. In addition, each article will answer three basic questions about the bioethical issue at hand: What is it? Why is it important? How should it be approached in practice?
How will we know whether the series has succeeded? Ideally, we would measure the performance of Canada's 50 000 physicians in interactions with their 25 million patients. Obviously, this is not feasible. Therefore, we ask for your comments. Let us know what you think of the articles. In particular, we would be interested in any impact the series might have on your practice. We look forward to hearing from you.