Ikaneng Yingwane, third year medical student at Sefako Makgatho Health Sciences University, looks at how ethics is taught at medical school

The path to becoming a healthcare professional is a difficult and transforming one that goes beyond acquiring medical knowledge and technical abilities. As medical students we find ourselves at the crossroads of medical science and ethics, confronted with a slew of moral dilemmas that test our values, ideals, and decision-making abilities.

These dilemmas frequently arise during interactions with patients, peers, and the healthcare system, where the pursuit of the greatest standards of care must coexist with complex moral considerations. Moreover, they extend beyond medical school years, spanning well into professional practice, and so navigating these dilemmas is an invaluable skill which every medical student should aspire to attain out of medical school. Here are some ethical dilemmas which you can expect to encounter during your years as a medical student: 

1. Patient confidentiality: Patient confidentiality is a crucial ethical principle in healthcare. Medical students are frequently trapped in a delicate balance between learning from real patient cases and protecting those individuals’ privacy. The era of digital interconnectedness within which we find ourselves now serves to make that ideal much harder. The temptation to share medical experiences on social media has resulted in various breaches of patient confidentiality and has resulted in litigious action against the medical students implicated. The bottom line is during your time in medical school, you are obligated to keep in check what you post online. Not protecting a patient’s privacy is tantamount to causing them great harm, which would be contradictory to your role as a future medical doctor.
   
2. Informed consent: This concept falls under respecting the autonomy of patients (which is actually law as outlined by the National Health Act (Act 61 of 2003)). In a nutshell it is about giving patients enough information for them to make informed decisions about what happens to their bodies. Medical students may be involved in discussions with patients about treatment options, risks, and benefits, which are part of the informed consent process. However, even though they may be involved in these discussions, they are not always knowledgeable about the complexities of medical procedures. Striking the right balance between involving students in the informed consent process and ensuring that patients truly understand the implications of their decisions is difficult. This has the potential to indirectly impinge on the autonomy of patients.

    

3. Resource distribution: Resource distribution, particularly in the context of healthcare, is plagued with ethical dilemmas. Medical students may be witnesses to or participants in choices concerning the allocation of scarce resources, such as organ transplants or medical treatments. These circumstances frequently require challenging decisions that set one patient's needs against those of another. During medical school, you will get to explore the ethical implications of distributive justice, which emphasises the fair and equitable allocation of resources. It is critical to be prepared to participate in these conversations while retaining a patient-centred viewpoint.

    

4. Disclosure of errors: Another difficult challenge for medical students is the ethical requirement to reveal medical errors. Admitting mistakes can be difficult, and students may be concerned about the implications, such as damage to their reputation or legal action. Open and honest communication regarding errors, on the other hand, is critical for patient safety and preserving trust in healthcare. You will get to learn about the need for error disclosure to students, with an emphasis on ethical obligation over personal worries. 

Medical school doesn't just train students on the information and abilities needed to save lives, but also on the ability to traverse a complex environment of ethical dilemmas. The dilemmas presented are just a few examples; many more may emerge in clinical practice. To ensure that future healthcare providers can address these problems with competence and compassion, medical schools must prioritise ethics instruction. They can not only give exceptional medical care but also uphold the highest ethical standards in their work, which benefits both patients and the profession as a whole.

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