Proximity morality in medical school--medical students forming physician morality "on the job": grounded theory analysis of a student survey.
BACKGROUND
The value of ethics education have been questioned. Therefore we did a student survey on attitudes about the teaching of ethics in Swedish medical schools.


METHODS
Questionnaire survey on attitudes to ethics education with 409 Swedish medical students participating. We analyzed > 8000 words of open-ended responses and multiple-choice questions using classic grounded theory procedures.


RESULTS
In this paper we suggest that medical students take a proximity morality stance towards their ethics education meaning that they want to form physician morality "on the job". This involves comprehensive ethics courses in which quality lectures provide "ethics grammar" and together with attitude exercises and vignette reflections nurture tutored group discussions. Goals of forming physician morality are to develop a professional identity, handling diversity of religious and existential worldviews, training students described as ethically naive, processing difficult clinical experiences, and desisting negative role modeling from physicians in clinical or teaching situations, some engaging in "ethics suppression" by controlling sensitive topic discussions and serving students politically correct attitudes.


CONCLUSIONS
We found that medical students have a proximity morality attitude towards ethics education. Rather than being taught ethics they want to form their own physician morality through tutored group discussions in comprehensive ethics courses.
Department of Clinical Sciences Malmö, Division of Family Medicine, Lund University, Sweden. hans.thulesius@ltkronoberg.se
Hans O
HO
Thulesius
Karl
K
Sallin
Niels
N
Lynoe
Rurik
R
Löfmark
D000328:Adult; D002982:Clinical Clerkship / Q000941:ethics*; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007587:Job Description; D008297:Male; D009014:Morals; D010819:Physician's Role; D013337:Students, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013548:Sweden