Changing attitudes about end-of-life decision making of medical students during third-year clinical clerkships.
To better define the learning objectives of ethics curricula and evaluate changes in medical students' attitudes about end-of-life decision making, enrolled students (N = 96) of a pilot medical ethics program were surveyed at the beginning and end of their third-year clinical clerkship about their experiences and attitudes about end-of-life decision making. At the end of their clinical clerkship year, the majority of students had participated in end-of-life decisions, prioritized patient autonomy and quality-of-life issues, were concerned about legal liability, were polarized over issues such as physician-assisted suicide, and gained confidence in their ethical decision-making ability. To train future physicians such that clinical practice is consistent with ethical guidelines and legislation on end-of-life care, medical ethics curricula should focus on symptom relief, clarification of legal issues, and resolution of conflicts between personal beliefs and public opinion about such issues as physician-assisted suicide. Appropriate role-modeling and mentoring by residents and attending physicians should also be emphasized.
Hayes
R P
RP
Emory University Center for Clinical Evaluation Sciences, Atlanta, Georgia, USA. rhayes@klwi.org
Stoudemire
A S
AS
Kinlaw
K
K
Dell
M L
ML
Loomis
A
A
D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D002982:Clinical Clerkship; D003479:Curriculum / Q000592:standards; D003657:Decision Making; D004992:Ethics, Medical / Q000193:education*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016555:Matched-Pair Analysis; D010865:Pilot Projects; D013337:Students, Medical / Q000523:psychology; D013727:Terminal Care / Q000379:methods / Q000523:psychology / Q000592:standards