The value of an oath of professional conduct: process, content, or both?

...I would suggest that the major objectives of studying the Hippocratic Oath or other pertinent oaths and codes are fourfold. First, studying oaths and codes pertaining to medical conduct and standards enables students to learn about historical changes and cultural influences. Second, choosing an oath or developing one for recitation at graduation enables students to engage in conceptual and moral reasoning. Third, the deliberations and discussions involving students enable them to practice interactional, communication skills about highly charged issues. Fourth, the identified limitations of the Hippocratic Oath or other pertinent oaths and codes enable students to appreciate the value of the broader principles that support medical ethics...The remainder of this commentary is divided into two parts. In the first part, recommendations for an educational program are presented. In the second part, recommendations for future research in this area are offered.     

Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

Reverence and Ethics in Science

Codes of ethics abound in science, but the question of why such codes should be obeyed is rarely asked. Various reasons for obeying a professional code have been proposed, but all are unsatisfactory in that they do not really motivate behavior. This article suggests that the long forgotten virtue of reverence provides both a reason to obey a professional code and motivation to do so. In addition, it discusses the importance of reverence as a cardinal virtue for scientists drawing on the ideas of Paul Woodruff on the role of virtue in community.     

Time for a unified approach to medical ethics

A code of ethics is used by individuals to justify their actions within an environment. Medical professionals require a keen understanding of specific ethical codes due to the potential consequences of their actions. Over the past thirty years there has been an increase in the scope and depth of ethics instruction in the medical profession; however the teaching of these codes is still highly variable. This inconsistency in implementation is problematic both for the medical practitioner and for the patient; without standardized training, neither party can be assured of the practitioner's overall depth of knowledge. Within the field of ethics certain principles have reached a consensus of importance. Incorporation of these concepts in meaningful ways via a consistent curriculum would provide students with an appropriate skill set for navigating their ethical environment. Moreover, this curriculum should also be extended to residents and professionals who may have missed formal ethical training. This would provide a consistent framework of knowledge for practitioners, creating a basis for clear judgment of complex issues.     

Authorship Ethics: Issues and Suggested Guidelines for the Helping Professions

The authors review the literature and explore common ethical dilemmas related to publishing research. Varying standards are presented to assist professionals and students in their publication endeavors. Joint research collaboration in many graduate programs is encouraged and appears inevitable. Joint research activities may involve student–faculty collaboration or professional peer collaboration. Although many helping professions have ethics codes that address publication issues, there is no standard among them regarding the issue of authorship. Although it appears necessary to follow minimal codes of ethics regarding authorship, consideration of suggested guidelines and aspirational ethics may enhance the professional growth of mental health professionals and students in mental health programs.     

A professional ethics learning module for use in co-operative education

The Professional Practice Program, also known as the co-operative education (co-op) program, at the University of Cincinnati (UC) is designed to provide eligible students with the most comprehensive and professional preparation available. Beginning with the Class of 2006, students in UC’s Centennial Co-op Class will be following a new co-op curriculum centered around a set of learning outcomes Regardless of their particular discipline, students will pursue common learning outcomes by participating in the Professional Practice Program, which will cover issues of organizational culture, technology, professional ethics, and the integration of theory and practice. During their third co-op work term, students will complete a learning module on Professional Ethics. To complete the learning module students must familiarize themselves with the code of ethics for their profession, create a hypothetical scenario portraying an ethical dilemma that involves issues covered by the code, resolve the dilemma, and explain why their resolution is the best course of action based upon the code of ethics. A three-party assessment process including students, employers and faculty complete the module. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Pantagruelism: A Rabelaisian inspiration for Understanding Poisoning,Euthanasia and Abortion in The Hippocratic Oath and in Contemporary Clinical Practice

Contrary to the common view, this paper suggests that the Hippocratic oath does not directly refer to the controversial subjects of euthanasia and abortion. We interpret the oath in the context of establishing trust in medicine through departure from Pantagruelism. Pantagruelism is coined after Rabelais' classic novel Gargantua and Pantagruel. His satire about a wonder herb, Pantagruelion, is actually a sophisticated model of anti-medicine in which absence of independent moral values and of properly conducted research fashion a flagrant over-medicalization of human problems. Ultimately this undermines the therapeutic core of medicine itself. We contend that PAS is a case of such over-medicalization and that its institution creates medicophobia. This article does not express an opinion about euthanasia in general. Rather, we claim that physicians should learn from the oath and from Rabelais that they should keep their practice to medical care and not to exploit their expertise and social privileges for the sake of ulterior motives, even when their patients desire those goals.     

Teaching ethics and technology with <Emphasis Type="Italic">Agora</Emphasis>, an electronic tool

Courses on ethics and technology have become compulsory for many students at the three Dutch technical universities during the past few years. During this time, teachers have faced a number of didactic problems, which are partly due to a growing number of students. In order to deal with these challenges, teachers in ethics at the three technical universities in the Netherlands — in Delft, Eindhoven and Twente — have developed a web-based computer program called Agora (see www.ethicsandtechnology.com). This program enables students to exercise their ethical understanding and skills extensively. The program makes it possible for students to participate actively in moral reflection and reasoning, and to develop the moral competencies that are needed in their later professional practice. The developers of the program have tried to avoid two traps. Firstly, they rejected, from the outset, a cookbook style of dealing with ethical problems that applied ethics is often taken to be and, secondly, they wanted to design a flexible program that respects the student’s as well as the teacher’s creativity, and that tries to engage students in moral reflection. Agora meets these requirements. The program offers possibilities that extend beyond the requirements that are usually accepted for case-exercises in applied ethics, and that have been realised in several other computer models for teaching ethics. In this article, we describe the main considerations in the development of Agora and the features of the resulting program.     

Social Responsibility and the Mental Health Professions

Summary

While mental health professionals tend to primarily focus on their professional responsibilities toward the specific members of the public whom they serve, many are also concerned about positively impacting the broader society or culture in which they live and work. This notion of social responsibility is addressed in the ethics codes of both psychologists and social workers. This article reviews how this notion is addressed for these two mental health professions and also examines the changes that have occurred for psychologists between the 1992 and 2002 ethics codes. Finally, some general issues regarding the role of mental health professionals in changing society are considered.     

Evoking the moral imagination: Using stories to teach ethics and professionalism to nursing,medical, and law students

Four years ago, as colleagues in our university's law and medical schools, we designed and began offering a course for law, medical, and nursing students, studying professionalism and professional ethics by reading and discussing current and earlier images of nurses, doctors, and lawyers in literature. We wanted to make professional ethics, professional culture, and professional education the objects of study rather than simply the unreflective consequences of exposure to professional language, culture, and training. We wanted to do it in an interdisciplinary course where aspiring professionals could share their self-conceptions and their conceptions of each other, and we wanted to do it by using stories, our primary means for organizing experience and claiming meaning for it. This article tells the story of that experience: why we did it; how we did it; what we learned from doing it.     

Utilitarianism and the Evolution of Ecological Ethics

R.M. Hare’s two-level utilitarianism provides a useful framework for understanding the evolution of codes of professional ethics. From a Harean perspective, the codes reflect both the fact that members of various professions face special kinds of ethically charged situations in the normal course of their work, and the need for people in special roles to acquire various habits of thought and action. This highlights the role of virtue in professional ethics and provides guidance to professional societies when considering modifications to their codes. From a Harean perspective, a professional society should ask both “Are there kinds of situations that members of this profession will normally encounter which members of other professions and/or the general public will not?” and “What habits of thought and action would it be good for individuals encountering such situations to have?”     

Students' perceptions of their future professional behavior

Doctoral students from university-based clinical, counseling, and school psychology programs responded to items that asked how willing they would be to engage in various professional activities and the reasons for their choices. The data were factor analyzed; five subscales resulted that were analyzed in a one-way MANOVA. Results indicated similarities between clinical and counseling for therapy and medically related disorders (Subscale 1) and specialized assessments and techniques (Subscale 4); and similarities among all three specialties on academic activities (Subscale 5). Traditional differences were also found: school students were more likely to endorse activities related to children and schools (Subscale 2); whereas counseling students were more likely to endorse activities related to consultation, educational—vocational counseling, and evaluation (Subscale 3). The results support current similarities and historical differences among the specialties and raise questions regarding education of and future career opportunities for psychologists.     

Ethics for all: Differences across scientific society codes

Ethics codes of a number of scientific societies across different disciplines promulgate ethical standards for responsible conduct in research and other professional activities. The content of these codes of ethics are compared on key dimensions of research, service or practice, and teaching in terms of the range and specificity of the activities these codes cover, and in the degree to which they are educational, aspirational or regulatory in purpose. The role of professional associations in educating, regulating, monitoring, and sanctioning their membership is also discussed. An earlier version of this paper was presented at the AAAS-Office of Research Integrity (ORI) meeting in Washington DC on the theme: “The Role and Activities of Scientific Societies in Promoting Research Integrity” held on April 10–11, 2000.     

Influence of Familial Spirituality: Implications for School Counseling Professionals

This article (a) addresses the importance of familial spirituality on students' holistic development; (b) explores professional ethical codes, standards, and counseling competencies relating to students' familial spirituality; (c) introduces educational activities to assist school counselors in increasing their understanding and appreciation of the influence of familial spirituality on students' behavior; (d) reviews a case study of a counselor integrating the suggested strategies in support of students and families; and (e) provides implications for professional school counseling.     

Gifted Achievers and Underachievers: A Comparison of Patterns Found in School Files

Underachievement in gifted students has perplexed educators and parents for decades. Researchers are continually looking for information about the nature and patterns of gifted underachievers that will enlighten those concerned. Counselors are particularly involved, because they often are asked to provide illumination and interventions. This study demonstrates how information in the cumulative school file, accessible to the school counselor, is a rich resource for understanding the patterns of achievement and underachievement among students identified as gifted and for use in planning interventions for students at risk for underachievement. Participants were gifted students (N = 153) who were determined to be either achievers or under-achievers, based on their grade point average at graduation. High and moderate achievers and moderate and extreme underachievers were compared on information found in the school file, such as attendance, tardiness, course selection, and onset and duration of underachievement. Results indicate that there are differences between achievers and underachievers on a number of variables found in the school files. Profiles of these groups are presented with suggestions for actions by counselors.     

Reflecting on – traditions,ceremony, and the formation of bachelor-prepared nurses

In this article, we explore the ways that the traditional nursing oath ceremony might serve as a reflective transformative moment for first-year students as they take their first tentative steps in a developmental journey of being and becoming registered nurses. Traditions in professional programs act as a rite of passage and hold the promise of an invitation and a new sense of belonging. This discussion explores the possibilities that exist within reflective transformative learning moments. The discussion unfolds through our eyes as nursing faculty teaching in an undergraduate nursing program. We recall our experience of practicing with first-year nursing students, and discuss the age-old debate: is the focus of teaching delivering content, or the formation of practitioners?     

A Cross-Sectional Examination of International Competency Standards

The evaluation of competency in the field of psychology has gained international attention in recent years. Focusing on international competencies can promote high standards of care and identify common values of the profession. However, there is little research regarding international perceptions of competency. Examining ethics codes from different countries can highlight international standards of competent practice, as ethics codes outline professional expectations of the field. The current study compared the ethics standards found in 47 codes of ethics representing 51 countries. Seventeen competency standards emerged after ethics codes were analyzed. Implications for the international practice of psychology are discussed.