Interdisciplinary Ethics Certificate Program for Graduate Medical Education Trainees

ABSTRACT Background Ethics education is an essential component of developing physician competency and professionalism. Although prior studies have shown both a wide interest and a need for ethics education during residency, structured learning opportunities are not widely available at the graduate medical education (GME) level. Objective Through the Vanderbilt Center for Biomedical Ethics and Society, we developed a 1-year certificate program offering a Distinction in Biomedical Ethics, open to all active trainees in GME programs at the Vanderbilt University Medical Center. This certificate program provides advanced education in biomedical ethics and can be completed without additional cost to the trainee or time away from training. Methods This certificate program has been offered each academic year since 2017–2018. The program curriculum includes case-based seminars, a rotation on the Ethics Consultation Service, participation on the hospital ethics committee, and a capstone project. Outcomes were assessed using a post-course evaluation. Results During the first 4 years of the program, 65 trainees participated from 19 different specialties. Course evaluations were obtained from 58 participants (89.4% response rate) and were strongly favorable in most domains. All participants agreed that this program enhanced their knowledge of biomedical ethics and they would use something they learned in their future practice. Most participants (57 of 58, 98.3%) would recommend this course to a friend. Conclusions We designed and implemented a Distinction in Biomedical Ethics program to provide advanced training in clinical Bioethics, which has been favorably received by participants.

Ethics experts and fetal patients: a proposal for modesty

Background Ethics consultation is recognized as an opportunity to share responsibility for difficult decisions in prenatal medicine, where moral intuitions are often unable to lead to a settled decision. It remains unclear, however, if the general standards of ethics consultation are applicable to the very particular setting of pregnancy. Main text We sought to analyze the special nature of disagreements, conflicts and value uncertainties in prenatal medicine as well as the ways in which an ethics consultation service (ECS) could possibly respond to them and illustrated our results with a case example. Ethics facilitation and conflict mediation, currently, have no broadly consented normative framework encompassing prenatal diagnosis and therapy as well as reproductive choice to draw on. Even so, they can still be helpful instruments for ethically challenging decision-making in prenatal medicine provided two additional rules are respected: For the time being, ECSs should (a) refrain from issuing content-heavy recommendations in prenatal medicine and (b) should not initiate conflict mediations that would involve the pregnant woman or couple as a conflict party. Conclusion It seems to be vital that ethics consultants as well as health care professionals acknowledge the current limitations and pitfalls of ethics consultation in prenatal medicine and together engage in the advancement of standards for this particularly complex setting.