Medical students feel pressure to act unethically, and often see their teachers doing so, a study of Canadian students released today in Britain finds.
The study published in the British Medical Journal found that nearly half of medical students felt under pressure to act unethically during training and almost two-thirds regularly witnessed a clinical teacher behaving unethically.
One example of the unethical behavior included not telling a patient he had lung cancer because the team of physicians didn't know what type of cancer it was. In another example, a student was left to close a wound on a patient even though the student wasn't sure how.
'Whopping' Number Act Unethically
More than 100 clinical students who were about one year away from completing medical school at the University of Toronto were surveyed about their ethical dilemmas for the study. Nearly half reported they had been placed in a clinical situation in which they "felt pressure to act unethically and a whopping 61 percent reported witnessing a clinical teacher acting unethically."
"The results of the study are perturbing to say the least," said Dave Robertson, a University of Toronto medical student and one of the co-authors of the study.
"There should be moves to change this sort of phenomenon," he said. "It has been documented through the years going back to the 1950s. There has always been this feeling and indication that doctors do not fully respect a patient's autonomy and that is alarming. But I do believe that attitude is changing."
A policy to help prevent the abuses of both patients and students in medical school is needed, according to an accompanying editorial by Len Doyal, professor of medical ethics at St. Bartholomew's and the Royal London School of Medicine. The researchers agreed in their findings and said the study is relevant for medical education throughout the world, including the United States.
"This will ensure that the students of today will be proud rather than distressed that they have chosen to be the doctors of tomorrow," Doyal wrote.
The students indicated in focus groups that they didn't feel comfortable discussing their ethical dilemmas with their teachers, for example when patients were made subjects for educational purposes beyond their need for medical treatment. One student, for example, said a patient was forced to be used as a teaching tool for students for four long hours.
"We were all very intimidated [by the teacher]. We thought it was inappropriate and we all talked about it later, but he [the teacher] put us in a position where we were scared to death of him. We were afraid to say anything, although he was probably wrong."