Brian Cox
  • Brian Cox
  • Cardiff By The Sea, CA
  • United States

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Should medical ethics be taught in medical school?

Over the course of the summer, I am embarking on a fairly comprehensive examination of medical ethics curriculum in the medical schools of the UK, Ireland, Canada, and America. I will be conducting focus groups and distributing surveys to understand how medical students view their competency in dealing with ethical issues, especially those encountered at the end-of-life.

I hope to use this information to make specific curriculum amendments that will allow future doctors to confidently manage terminally ill patients.

However, I need your help.

In order to make my study even more robust, I wish to garner as many perspectives as possible. Please contribute your opinions, your experiences, your attitudes and beliefs. Tell me how doctors deal with end-of-life issues: how they have managed your family and friends.



*The first comment gives a little background on the current state of medical ethics in the UK. It is an excerpt from my proposal earlier this year.

  • Jul 11 2012: Hi, Brian. Yes, ethics should definitely be taught as part of medical school. I'm a professor of philosophy and ethics, and I'm currently pursuing a second degree specifically in bioethics. People often approach ethics with the attitude that studying it is of no real value. As someone who has spent the past 20 years doing just that, I can assure you that's not the case. Philosophy, and by extension ethics, is just like anything else - the more you do it, the better you become at it. Not all explanations are created equal.

    That being said, the current trends in spirituality and medicine (where spirituality isn't defined as exclusively "religious" but merely as whatever is at the core of one's source of meaning in life...family, appreciation of nature, altruistic acts, etc.) begin from the idea of treating patients as a person (i.e. a being with a set of beliefs, values, ideals, hopes, concerns, personality traits, etc.) rather than merely treating an illness or a symptom. Ethics is about how we weigh values, often in relation to a conflicting sense of duty. If we can consider such things in advance, it makes it easier to know what to look for, think about, and consider before we have to do so when we're interacting with people when it really matters. Two things I tell my own students at the beginning of every semester are that if we're going to even attempt to do philosophy well, we need to always keep in mind 1) make no assumptions (or as few as possible) and 2) just because you've heard something all your life doesn't make it true. Most of the students in my current graduate courses are medical students and my program is in the school of medicine, not philosophy; and they all the time make assuptions that philosophers wouldn't simply because of their background. If we combine the two disciplines, everyone benefits. Philosophers who attempt bioethics without any medical science are at an equal disadvantage as doctors who have no exposure to ethics.
  • Jun 30 2012: Hi, I am a final year medical student from NZ. We have been taught medical "ethics" throughout our clinical years. I put the ethics part in quotation mark as I do think that there is a component of ethics that stems from the morals and values that we develop from childhood. Our teaching was based around autonomy, non-malificence, beneficence and justice. From this base we were encouraged to build discussions and arguments around case. We were always challenged to bring our own views and to try to look at things from all angles. There were many learning points were based around autonomy and competence. I found the teaching really useful in that it has helped me to develop my thinking and has given me a structure to refer back to when I come across a challenging case. We didn't have much teaching specifically about end of life care but I feel that with the base that I have I will have some confidence in my approach to such problems. Separate to out ethics teaching we have had a few sessions on breaking bad news which I found helpful but nothing can compare to witnessing it being done. But it was really nice to have a palliative care physician talk to us about his experiences. I have had a quick glance though the previous comments and see that someone suggested that you include australia. I imagine that aus and NZ have a similar curriculum. Let me know if you want to know more about my medical school and I can give you more details.
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      Jul 5 2012: Hey Stancy, sorry for the delayed reply, I've been conducting and transcribing focus groups with medical students. I'm very interested in what appears to be an apparent difference in Australia/NZ and UK teaching, especially considering the two countries are British colonies. I probably will not be examining Australia/NZ this time around, but I'm on elective next summer. It would be interesting to followup some of this data through the Medical Ethics Institute out by you guys. If you can send me a message, I'd like to ask you just a few questions. I'm pretty wary about putting my email up on a public forum, but if you'd like, you could message me via facebook https://www.facebook.com/brian.k.cox. If not, no worries. Thanks for the comprehensive reply!
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    Jun 28 2012: I'm pursuing my masters in education and we learned medical ethics as part of one of our courses. The purpose of learning this in education was because we deal with vulnerable children, as is the case with doctors too - dealing with vulnerable patients. It's important for people in these professions (that deal with a vulnerable people) to know how to empathize and understand that their role in their these peoples lives isn't just something in passing.

    From my experience of learning medical ethics as an education student I can say that it is highly valuable and concur that ethics is something that is engrained from childhood and home life. If you don't have an ethically sound upbringing then learning about medical ethics can be quite surprising and new, and difficult to grasp. Ethics can also vary culture to culture.
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      Jul 5 2012: Yes, definitely. I'm looking into improving the curriculum through an examination of cultural differences and how to respond empathetically to a diversity of groups.

      The world needs great teachers, wish you the best in your pursuit!
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    Jun 28 2012: With my shallow knowledge I am aware of that all medical students go through Hippocratic oath at least, which is pretty good base for medical ethics till today.....how much of those ethics are practiced in real professional life setting as a whole ?

    My feeling is, it is better to think how can we bring ethics in practice what we learnt whether from familial , societal or institutional setting............
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      Jul 5 2012: The idea of "auditing" ethical practices is an interesting idea. I've written it down to research whether it has been done before.
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        Jul 6 2012: Thanks for your compliment......would love to know your findings of such research as well......
        My feeling is how to get right response from the respondents can be a challenge....as the most unethical person in practice seems most ethical in talking that's what my experience is.......I have no doubt you have the expertise to unmask respondents tactically to get real answer.....

        All the best with your research.
  • Jun 28 2012: It is not a question IF Ethics should be studied. It's rather HOW, or in which manner should the matter be presented to students.

    The presentation of seemingly impossible dilemmas to students who are at the beginning of their medical education (f.e. 1st year of medical school) leads to fruitless discussions.

    However, students at a later stage of education should be stimulated to utilize their acquired knowledge, therefore ethical discussions can be infused with actual medical facts. In addition, experienced doctors could be invited to share their own stories and views on certain subjects.
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      Jul 5 2012: You nailed it. Currently ethical teaching is considered to be formal, informal, or hidden. Formal teaching is comprised of lectures, seminars, etc. while informal teaching is the reflective aspect of some tutorials and discussions. The "hidden" curriculum is the idea that medical ethics is pervasive throughout the hospital, and students witness good ethical practice subconsciously. However, it appears there is a drive to make teaching substantial and lasting but in a more formal manner. Medical students need to be engaged in the discussion of medical ethics early, but discussions (as you said) which do not lead to impossibly "grey" outcomes.
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    Jun 26 2012: I assumed medical ethics are already part of medical curricula. Don't most professions include training in the ethics of the discipline?
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      Jun 26 2012: Medical ethics is part of a curriculum, but teaching is not universal nor is it comprehensive.

      As a result, many individuals receive "informal" or "hidden" teaching. That is, you learn as a witness and through reflection. However, the eventuality of this practice may lead to the adoption of bad habits. It is therefore necessary for students to receive more "formal" teaching. Scripted scenarios and tutorial based learning are essential if medical students join the workforce with competency in end-of-life issues.
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        Jun 26 2012: Case studies seem like an effective vehicle for such a curriculum. In a business school, a law school, a teacher training program, a public affairs school... ethics is often addressed by putting forward case studies for discussion.
  • Jun 28 2012: My own understanding(I am a Doctor myself) is that Medical ethics or any ethics can't be taught in medical schools... it's something that has to be inculcated since childhood... at home, in junior school, senior school, higher education.... and "life". All Doctors sign the "Hippocratic Oath" at the time of registration, but do most Doctors follow them?
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      Jul 5 2012: It's difficult to know whether ethics should be taught as apparently as math, english, and science, or whether it should "informally" be taught through experience and reflection. Surely we know right from wrong, but in the complicated world of medicine, it is sometimes not a question of what "can" we do, but what "should" we do? The Hippocratic Oath is a reflection of the ethical tenets, but it may not always govern our actions. "Doing no harm" can have many interpretations, unfortunately.
    • Jul 11 2012: Ethical theory can definitely be taught. I spend every day of the week doing it. The idea that something can't be taught simply because there are no strict answers, as one expects to find in sciences and other disciplines, is mistaken. Philosophy is about abstract critical thinking, not memorizing empirical facts. They're just two different ways to approach knowledge, and each has its own purpose, function, and merits. And ethics is always about what we ought to do, if you're talking about what we "can" do, then you're no longer talking about ethics. That's the difference between normative (evaluative) and non-normative (purely descriptive) statements. Ethical considerations are always normative, because they attempt to assess or evaluate. For example, one theory (often mistaken as an ethical theory) is psychological egoism, which simply states we observe that humans tend to act in self-serving ways. That's a purely descriptive statement, it doesn't attempt to prescribe anything. Its "sister" theory is ethical egoism, which states that if we do, in fact, observe people to behave as such, then people "ought" to do so, because they're simply acting on human nature. The latter of these two statements is normative, because it's prescribing what one ought to do...that's the realm of ethics.
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    Jun 28 2012: In a manner of speaking it is already covered. Your bedside manner is critiqued and discussed. If I could suggest ... hospitals have staff that counsel and refer families in death situations. I would be there for the announcement of the cause and answer medical questions and then sincerly offer condolences on the passing and turn them over to the professionals. You have a speciality and so do they each of you should respect the areas of the other.

    All the best. Bob.
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      Jul 5 2012: But is it too late if you're practicing the art of breaking bad news at the bedside?
  • Jun 27 2012: I see end of life issues being mentioned a lot in these comments. While those issues are dramatic, ethics is involved in every aspect of an industry that should be centered around care. Any issue that negatively affects the quality of care is an injustice to the patient. Examples: the relationship of care giver to third parties such as drug companies, equipment suppliers and especially insurance companies; the doctor nurse relationship; mistakes that cause patients to get new infections in hospitals, many of them dying. When medical care is so expensive that many people can't afford needed care, the compensation of the care givers is an ethical issue.

    I think that ethics should be taught as a separate class in each year of medical school and in every class it should be emphasized that quality of care is an ethical issue.
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    Lejan .

    • +1
    Jun 27 2012: Isn't it taught in medical school already? If it isn't the question may then start with 'why'...

    I think any end-of-life situation - where possible - should be based on 'free will' from inside and outside the sick-bed to keep both parties in their very own dignity at any time.

    Teaching medical ethics may help the student to learn about it, yet it does not and should not prevent him and her to reflect and decide for themselves on this issue. May this decision be general or case specific later on. But to feel comfortable with whatever decision one makes, it will probably have helped to have learned about it. And if it doesn't it would not do any harm.

    The conflict caused by the hippocratic oath in those situations lays in the oath istelf, which could be changed if it proofs
    obstructive in finding a personal decision for a doctor. It has been written by men, it could be changed by men if it helps avoiding moral conflicts out of itself.

    I can only say that if I ever have to make a decision for myself to end my life because I wan't it to, I would be grateful and honored if my doctor agreed on helping me by this. Also I have to honor and respect if he or she choses not to, yet knowing who would, would be helpful at that pont in time.
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    Jun 27 2012: Dear Brian, teach me how to help and I will.
    I hope you feel well today (and every day)
    Debra
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    Jun 27 2012: Maybe medecine should be taught in elementary schools (at least the basic). The medical industry is too big to be ethical.. and cost an arm to develop, while some simple knowledge and a peaceful environment could be much more proficient !
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      Jun 27 2012: Classes in ethics are surely forgotten until a high school/collegiate level. I think academic administrators view ethical understanding is a purely philosophical pursuit rather than an integral part of communication, empathy, and integrity. Starting early is a great idea!
      • Jul 11 2012: Exactly, Brian. Ethics could easily be characterized as the most practical branch of philosophy, because it addresses social behaviors, which is a subset of human behaviors.
  • Jun 27 2012: Of course it should, and so should medical systems.
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      Jun 27 2012: AGREED. System management is another major source of problems.
  • Jun 27 2012: I am a believer in medical ethics . I also support dying with Dignity. I am not a doctor, but if I was one, My primary goal would be to save lives,not end lives. But if I could not save the patient, I would try to help the patient die with dignity and grace. I would be respectfull, compassionate and professional to the highest degree.
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      Jun 27 2012: I agree with you wholeheartedly. However, finding a way to 'respectfully, compassionately and professionally' allow a patient to die with dignity while maintaining medical principles of 'do no harm,' presents a tremendous challenge. If you can figure out how to balance all elements of this problem, you would win a Nobel Prize.
      • Jun 28 2012: Hello Brian
        My answer is what I already have, And that is a Living Will ( Advance directive ). Which states that I am not to be resucitated or put on life support. It allows the doctor to respect my wishes ethically and legally. Its not a nobel prize winner. But in my case it is the right answer.
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    Jun 27 2012: I believe there is a solution. I think that people are all on different planes of thought, though we may be perceiving the same thing (glass half empty or half full.). I compare this to different denominators but the same idea. So, let's say I'm 1/2 and you are 2/4 . We have a different way to explain the same thing. The easily solution is to find a common denominator and work from there, thus allowing solutions to be in both yours and my terms.
    The same principle i illustrated here is apparent in Hegels philosophy: the synthesis is finding the common denominator of the thesis (your viewpoint) and the antithesis (my viewpoint).

    Yes, I think debates would work, as it is basically allowing a synthesis between the students, but then what happens when two people did not attend the same class or school? I think this is when ethics of a time period (bigger scale, no longer just in terms of an individual) comes into play. If we can get on common terms as a generation, we may teach ethics in that generation. Though, this would be very difficult...
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      Jun 27 2012: Thank you for your insight into Hegel's philosophy and the idea of a common denominator for consensus' sake.
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    Jun 26 2012: I am not a medical student, but I think the responsibility of a Doctor is very important topic.I think that a Doctor can not be personally held responsible for every mistake because in such an environment he will try not do admit any mistakes. If he does not admit them, others cannot learn from them so they will happen again. In a lot of cases mistakes are even not realized because the patient is passed to the next doctor. For plane accidents every country has a institution dealing with every single accident or close accident. (NTSB). There is a video series on youtube which then brings the human side back to the accident story: Example: http://www.youtube.com/watch?v=DyuSmPYF0YM

    The Pilots can talk about it and the passengers profit from this practice. I think is is a major issue in medicine. However it is not as easy to do "the right thing".
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    Jun 26 2012: Absolutley!
  • Jun 26 2012: Although this isn't related to end of life issues I have to bring up an issue that is related. The prescription pill epidemic in the United States has far surpassed the carnage of the crack epidemic. A multitude of doctors have been arrested for illegally prescribing prescription opiods, benzodiazapenes, and others.

    As a 24 year old living in NH,(which sits on the border of massachusetts, which has the highest opiod overdose rate per capita in the country) i have many friends who went from college students, to full blown addicts in a matter of weeks due to this scourge.

    Doctors need to have a better understanding of what it is they are actuality prescribing and how potentially addictive it is. The psychiatric community is also under siege for over medicating children with narcotic stimulants. I can count the number of people on my hands that don't take adderall to write a paper. Yes, at the end of the day the people taking the medication need to be responsible for what they put in their system.

    To me, it seems as though many doctors seemed to be happily deceived by patients who doctor shop. Kickbacks, rigged studies, and false marketing have been shown by numerous sources in regards to pharmaceutical companies.

    I can't tell you how much I agree that rigorous ethics should be taught in medical school. Something must be done to curtail the abuse of prescription medication and although profit seeking doctors seem to be only one part of the equation, it doesn't lessen the role it has played in this ongoing tragedy.
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      Jun 26 2012: Couldn't agree with you more. We live in a finger pointing society where everyone passes the blame.

      It is the responsibility of all parties involved - the patient, doctor, lawyer, judge, and pharmaceutical company - to ensure profits do not come before safety.

      And you may not have realized it, but opioids play a large role in patient management at end-of-life. There is something called the "Doctrine of Double Effect" (DDE). DDE states that although opioids are used to prolong life by reducing personal suffering, they are also simultaneously reducing respiratory rate and increasing side effects. Though the net result is a prolonged life, the argument is that life is prolonged at a cost.
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    Jun 26 2012: All professions should cover the legal and ethical considerations that are relevant.

    Given education is more centralised than working. This is a good place to start.

    Places of work (hospitals) also have an obligation to provide a policy framework and training in this regards etc. Ideally appropriate ethics should be built into the culture of all organisations.

    Personally, I support teaching ethics at school with an age appropriate curriculum.
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      Jun 26 2012: You very insightfully point out that education is centralized. I never thought of that before. It would be interesting to examine whether medical programs with similar curricula produce equivalent ethical competencies.
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    Jun 26 2012: Maybe you should include Australia in your investigation. An ethics class is a requirement for the first four semesters.
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      Jun 26 2012: In medical school? Can you describe what is covered? Many medical schools attempt to cover the topics of beneficence, malevolence, autonomy, etc. Additionally, they have classes on "breaking bad news" and talking to family members, yet many junior doctors still report apprehension in dealing with end-of-life issues. I am trying figure out why this is.

      I would be very, very interested to hear from you if you have time.
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        Jun 27 2012: Sorry Brian I have no knowledge of course content. I'm a highschool teacher so often have discussions with students regarding thier future after highschool. We get a book that lists the subjects studied for all courses offered at Australian universities so I looked up medicine and found ethics listed as a mandatory subject for 4 semesters. I'll see if I can find out a bit more.
        This page is a descrition of the course from the University of Queensland
        http://www.courses.uq.edu.au/student_section_loader.php?section=1&profileId=48085
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    Jun 26 2012: It is somewhat disconcerting to think that physicians would not be educated in medical ethics. There is so much involved in medicine that surrounds ethics. I also do not think it should be a comprehensive education in ethics but adequate information to make decisions and to be able to competently address an ethics board.

    There are medical ethicists who study ethics and who can be sought out as consults for complex cases. Much like there are medical specialists. But the truly complex cases need to be deliberated by a board or a community of care providers.

    Every physician has a set of ethics under which he/she operates. Two physicians can disagree about the same exact case. Over time, they learn about how other physicians practice and if they run into an ethical dilemma, they can refer.

    One person was requesting continuing futile medical treatment which one physician was uncomfortable initiating. That physician referred the patient to a research hospital physician who had no issue continuing treatment. Explained that he could not help but he knew someone who could.
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      Jun 26 2012: At that stage, medical ethical principles are often quite clear to the physician in question. What I am trying to examine is whether we need to start learning the complexities of medical ethics earlier in our career.
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        Jun 26 2012: I don't think you can arrive at that level of practice without the proper educational base from which to make decisions. Yes I think we all need it early in our careers.
  • Jun 26 2012: As a nurse who has dealt for many years with dying patients, I have one important idea to mention. Physicians have a moral responsibility to tell a patient when they are nearing the end of their life.
    I have been in the unfortunate position of being the bearer of this news. Frequently I feel that I often do not have all the details, while the person who did have the information, chose not to share them with the patient. Come on, doctors! Don't you think your patients deserve to hear the most important information in their lives from you? Just because it's something you can't fix, doesn't make it essential for you to deal with.
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      Jun 26 2012: It is a shame that you have been placed in such a position. These types of situations should not occur, but frequently do. Doctors need to feel comfortable and competent delivering bad news regardless of the circumstance so that individuals like yourself are not forced into an unfamiliar situation.
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    Jun 25 2012: I think this quote applies to this: "Never let the rules, overrule common sense".
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      Jun 26 2012: Now to find a way to teach common sense! :)
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    Jun 25 2012: I think doctors should be posed all sorts of ethical questions relating to their field etc and develop their own views that fit within guidelines such as, not trying hard enough for a critical patient just because they're an organ donor and their organs could be used elsewhere. Teaching around this sort of area such as medicine isn't just about having the highest net score of survival rates.
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      Jun 26 2012: Your pessimism is unfortunately common in the patient population. I think it may be due to the apparent and growing lack of trust that exists between today's doctor and their patient. Patient's would hope doctors have their best interest in mind, but it is often difficult to distinguish. To combat this, medical schools worldwide are trying to promote communication skills and empathy in their graduates. However, thus far, this has not wholly resulted in competency.
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    Jun 25 2012: I'm not sure if this is relevant to what is being asked, but I find myself questioning whether ethics can or should be taught anyways. It seems to me ethical values and such vary place to place, time to time and so the only way ethics really exist, much like norms, is by us acting as if they do and creating/empowering them.
    What if we were to get everyone on the same page and a problem in our way of thinking manifests itself? There will be no one to offer a different solution...
    • Jun 25 2012: There is truth in what you wrote but, even if values are changing, it is very important to find solutions to these kind of questions. I have not say an answer but a solution. Actually, we cannot stay here, timorous, saying that it is impossibe to solve these problems. There is a need to be "efficient".
      By efficient i do not want to say that we have to applicate a random solution and force people to deal with it. I just want to say that, in order to find a solution, the first step would be to largely talk about these problems. By the meantime it would be the occasion to break some taboos.
      As a consequence I totally agree with this enterprise which will be the occasion to talk about these problems but i am more sceptic about the idea of teaching "Medical ethics" because it is controversial by nature. So i cannot imagine lessons about that but rather debates for example.

      Thanks for read me.
    • Jul 11 2012: Hi, Alec. Your starting point with this explanation assumes that there are no such thing as moral absolutes, but that needn't be the case, even though, as you note, it certainly seems that way because of a lack of agreement. However, consider this example I pose to my own students as a possible explanation in favor of moral absolutes. I'm not claiming it's true; rather, I just use this as a tool to counter the "it's all relative" mindset students always have when they enter the class each semester. Let's use the analogy of xrays. There was a time when we knew nothing of the existence of xrays. It was only after we developed certain technologies that we knew of their existence, but we wouldn't make the claim that when we created the technology we, at the same time, somehow invented xrays. Rather, they were always there and we simply knew nothing of their existence. Similarly, couldn't one argue (as did people like Socrates and Plato) that moral absolutes are merely one more thing we haven't yet discovered about the universe? There's no logical contradiction there, regardless of how implausible that explanation "seems" to us. Our initial reaction is to state "That makes no sense. How could values exist in the abstract sense?" What might this tell us. Does it follow that simply because human being operate based on common-sense, therefore, so does the universe? Common-sense is a by-product based on our expectations about how things work, which doesn't in any way influence the truth about how things do work. It may turn out that we're right, and ethics/morals are always relative to a given frame of reference. However, claiming as much may also turn out to one day be proven otherwise. Or maybe (worst-case scenario) moral absolutes exist but are forever beyond our ability to discover them. Something's existence in no way is hinged upon our ability or inability to discover it.
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        Jul 11 2012: Speaking of Plato, you bring up my next point. It seems it doesn't matter, really, if there are moral absolutes or not, because they ( seem to be) unreachable. Much like the form of a human being can never be manifested into any one human being-there is mo synthesis for tall and short, black and white, black hair, blonde hair.. etc. All of which would have to coexist in a single human at the same time for it to truly represent all instances. In other words, a concept is a concept for a reason.
        It seems the idea of moral axioms, from this standpoint, is merely an idea. Whilst I'm not putting it down, I do think that it's more a "form" as Plato would call it that has many manifestations which we bring to the world, just as the form of a human being has many manifestations, some of which include you and I.
        On a side note- a part of me thinks that all axioms are simply supposed. Base 8 or 5, or 20, is just as good a base as 10, but we almost absolutely use base 10 today. Why? Just because that's what we've decided.
        • Jul 11 2012: You're taking Plato's theory of the forms out of context a bit. Forms don't have to manifest in a single being to validate their existence. In fact, you'd never find that, because they ARE abstractions. Take a look at how Socrates words his objections in the dialogs. When there's a call for definition, which happens at the outset of nearly every dialog, such as "What is justice?" in the Crito or again in the Republic, the secondary character begins by listing examples of things we consider just. Socrates then redirects by stating he's not interested in the examples. What he's asking is, if we were to make an exhaustive list of every last example of just things, what would be the common criteria among all of them that made us include them on this list? In other words, what is justice in the abstract sense? You'd never find the Forms manifested in material objects, because that's the distinction between universals (the Forms themselves) and particulars (specific objects that populate the universe). There's also a difference between moral absolutes and a "moral axiom." Be careful with your language here. An axiom is a self-evident truth and just because something may be absolute (i.e. universal) in no way implies that it's also self-evident. Yes, what you note about mathematics is true, but that's because mathematical truths, themselves, are definitional truths. As such, what's important is the relationships between the values and the symbols. Where you start is irrelevant as long as the same relationships hold. When you say "merely an idea," what is that meant to imply? Don't ideas exist? Ideas are, at the very least, brain energy and energy certainly exists. Existence isn't a generic term, meaning things don't simply exist in one manner of speaking. There are two basic ways things can exist, as either an object or as a concept. But concepts exist nonetheless. They aren't, in some way, "less real," because what does that mean?
        • Jul 11 2012: Additionally, asking for a synthesis between opposites is another error based on the assumption that existence is a generic term. It's what Gilbert Ryle referred to as a category-mistake. There's nothing to synthesize between tall and short, because these things only exist as matters of description. You don't have to find an average between short and tall (because you can't). What has actual existence is human beings (the object). Short and tall are just descriptions we give to the objects, similar to how there's no such object as a "crowd." "Crowd" is just a term we use to describe a collection of individuals, but the only actually existing objects are individual human beings. So, "crowd" is concpetual...which takes us back to the previously mentioned distinction about the fundamental categories of existence: 1) objects and 2) concepts.
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    Jul 24 2012: It is very important to have people of intergrity in the medical profession.
    A lot of factors would contribute to the moulding of an individual; even those in the medical profession. But it would be unwise, and even disastrous, not to try all that can be done, including teachings, laws and regulations, to make individuals better. So that they can be more effective as agents of life.
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    Jul 11 2012: "You don't have to find an average between short and tall (because you can't)"
    I agree that one cannot and this is my point. In order to put the absolute into the words as it *really* is, we would have to synthesize (and bear with me, as it's the best word i can think to use) all of the perspectives on it, as in this case, they are examples or manifestations of the concept, just as Socrates would combine examples (which is similar to the word perspective- an example is in a way a perspective of the concept) to find the concept of just.
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    Jul 11 2012: "Forms don't have to manifest in a single being to validate their existence. In fact, you'd never find that, because they ARE abstractions."
    Yes, exactly. What I'm trying to say is that precisely because instances of these concepts are abstractions, "imperfect" and individuated models of the concept, we cannot and will not arrive at the moral axioms we speak of.
    "In other words, what is justice in the abstract sense?"
    yes, this is the idea/concept/form i speak of, which produces the examples.
    "Don't ideas exist? Ideas are, at the very least, brain energy and energy certainly exists."
    It's a tricky thing to say and im not quite sure i can put it into words, but I'll try. When you speak of the concept/idea/form that makes the examples just, can it be, itself, made into an example? Of course not! It is just an idea. And of course it is real, as it may not be tangible or visible but it definitely effects the world, which is in some way real, at least. My point is, when I say "absolute" I associate it with form/idea/concept and since the idea itself can never be modeled perfectly, so, too, can an absolute be modeled perfectly by language. Not to say that language is insufficient, but just that regardless of the means, any way of manifestation will only be an example of the idea, not the idea/form/concept or absolute we seek.
    I think that humans can only be inspired by this absolute, to put it poetically, and then put it into their own words, but never be able to put the absolute, without bias or perspective, into words, as everyone will describe it differently.
  • Jul 6 2012: They definitely should.
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    Jul 5 2012: How do brian
    Quick question why would anyone let a doctor manage there family? Unless he was part of it. And what make you think that a doctor handles there death different from any one else? Please tell me if there is good money desinging a curculum for group that has almost no potential for being ethical.
    Now with all that said the medical profession is a bloated pig that has as much use as tits on a boar hog.
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    Jun 25 2012: In regard to the UK:

    "...Although the General Medical Council mandates medical students be equipped with medical ethics education, establishing a formal, structured medical ethics curriculum has proved difficult. In 2010, a consensus statement made by teachers of medical ethics and law expressed concerns with the status, content, delivery, and assessment of medical ethics in medical schools. The document discouraged reliance on “hidden” forms of medical ethical curriculum, stating that a medical student may inadvertently develop 'unacceptable habits and attitudes . . . through observing medical misconduct and mistaking it as the norm.'

    Additionally, the Institute of Medical Ethics claims such teaching is currently underrepresented in medical schools worldwide (Stirrat et al, 2010), causing newly qualified doctors to report apprehension when dealing with End-of-Life care (Sullivan et al, 2003)."