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The 2008 Flying Fickle Finger of Fate Ethics Awards

Health care news and events in 2008 provided ethics teachers a continual supply of case studies to update their curricula. Let’s face it, the past year may not stand out as a great year for patients, but it definitely provided a bumper crop for bioethicists in search of problems to discuss. My own morning ritual with the local newspaper never failed to yield attention-grabbing fodder for the online discussion boards. It seemed as if I could find relevant stories in just about every section of the paper: Local News, World News, Editorials and Opinions, Lifestyle, Business (most fruitful for medical research and industry), and even an occasional comic strip (a rerun of Peanuts reminded us all that Linus wants to be a "country doctor,” so that he can "be on the right side of the ol' needle”).

So, I think it only fitting to share my list of Top Ten Healthcare Stories for 2008. My very own 2008 "Flying Fickle Finger of Fate” ethics awards go to:

  1. Ever wonder if your doctor is laughing at you? http://www.cnn.com/2008/HEALTH/09/10/doctor.laughs/
  2. Harvard psychiatrist is paid stooge for big pharma. http://psychiatricnews.wordpress.com
  3. Executions pose dilemma for doctors. http://www.newsobserver.com/news/story/1160035.html
  4. Illegal aliens may fear to seek care. http://www.newsobserver.com/news/health_science/story/1182561.html
  5. Mental disorder: The failure of reform. http://www.newsobserver.com/2771/story/1300808.html
  6. FDA Abandons Declaration of Helsinki for international clinical trials. http://www.socialmedicine.org
  7. Physician’s conscience rule. A href="http://www.findingdulcinea.com">http://www.findingdulcinea.com
  8. Recruiting homeless people for unnecessary medical treatment. http://www.newsobserver.com/1566/story/1331806.html
  9. Harm can be found in many forms while under doctor’s care. http://abcnews.go.com/Health/Story?id=5771086&page=1
  10. The ugly business of Chinese organ harvests. http://www.france24.com

Individually, these stories were used to help guide well-reasoned discussions and promote an understanding of the key elements of professionalism and medical ethics. Taken collectively, however, I can’t help but wonder if these negative stories contribute to an overall student cynicism about the healthcare industry. No doubt, every class has both ‘formal’ and ‘informal’ lessons that are learned in, through, and around the main subject. The informal lessons or ‘hidden curriculum’ of a course in medical ethics can also influence student attitudes and behaviors. While teachers espouse altruism and accountability, the real-world is saying, “Make sure you get your share” and “Don’t forget to cover your backside.”

Problem-based learning and the use of case studies are used to put flesh and blood on abstract concepts like humanism, altruism, respect, and accountability. However, I am hoping that 2009 offers a turning point for promoting the development of ethics and professionalism in medicine. I don’t expect unethical practitioners will disappear, but I hope to see a new focus on positive events in healthcare. I would like to give students the opportunity to celebrate heroes and learn from positive role models. Since the time of Socrates, teachers have emphasized opportunities to learn ethical behavior by reinforcing positive role models. This time next year, I hope the Top Ten list consists of stories that were used to promote learning AND combat cynicism. Maybe then we can all be proud of being on “the right side of the ol' needle.”

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