title: Why medical schools are tolerant of unethical behavior.
abstract: The exposure to unethical and unprofessional behavior is thought to play a major role in the declining empathy experienced by medical students during their training. We reflect on the reasons why medical schools are tolerant of unethical behavior of faculty. First, there are barriers to reporting unprofessional behavior within medical schools including fear of retaliation and lack of mechanisms to ensure anonymity. Second, deans and directors do not want to look for unethical behavior in their colleagues. Third, most of us have learned to take disrespectful circumstances in health care institutions for granted. Fourth, the accreditation of medical schools around the world does not usually cover the processes or outcomes associated with fostering ethical behavior in students. Several initiatives promise to change that picture.
authors.affiliation: Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil eiovidal@fmb.unesp.br.
authors.forename: Edison Iglesias
authors.initials: EI
authors.lastname: de Oliveira Vidal
authors.affiliation: Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
authors.forename: Vanessa Dos Santos
authors.initials: Vdos S
authors.lastname: Silva
authors.affiliation: Public Health Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
authors.forename: Maria Fernanda Dos
authors.initials: MF
authors.lastname: Santos
authors.affiliation: Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
authors.forename: Alessandro Ferrari
authors.initials: AF
authors.lastname: Jacinto
authors.affiliation: Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
authors.forename: Paulo José Fortes Villas
authors.initials: PJ
authors.lastname: Boas
authors.affiliation: Anesthesiology Department, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
authors.forename: Fernanda Bono
authors.initials: FB
authors.lastname: Fukushima
mesh_terms: D000068:Accreditation / Q000592:standards; D004645:Empathy; D004992:Ethics, Medical; D004995:Ethics, Professional; D005180:Faculty, Medical / Q000592:standards*; D006801:Humans; D011361:Professional Competence / Q000592:standards*; D000068616:Professionalism / Q000592:standards*; D012577:Schools, Medical / Q000941:ethics* / Q000592:standards; D013337:Students, Medical
keywords: empathy; medical education; professional competence; professional ethics