Psychosomatics 40:205-211, June 1999
© 1999 The Academy of Psychosomatic Medine
Changing Attitudes About End-of-Life Decision Making of Medical Students During Third-Year Clinical Clerkships
Risa P. Hayes, Ph.D.,
Alan S. Stoudemire, M.D.,
Kathy Kinlaw, M.Div.,
Mary Lynn Dell, M.D., Th.M., and
Amy Loomis, A.B.
Received July 14, 1998; revised September 18, 1998; accepted October 7, 1998. From Emory University Center for Clinical Evaluation Sciences, Atlanta, Georgia; Kerr L. White Institute for Health Services Research, Decatur, Georgia; Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia; Emory University Center for Ethics in Public Policy and the Professions, Atlanta, Georgia; and Emory University, Atlanta, Georgia. Dr. Dell is currently with the University of Pennsylvania, Department of Psychiatry, Philadelphia. Address correspondence and reprint requests to Dr. Hayes, 101 W. Ponce de Leon Avenue, Suite 610, Decatur, GA 30030–2542; e-mail: rhayes{at}klwi.org Requests for reprints of the ethics course syllabus should be directed to Kathy Kinlaw, M. Div., Emory University Center for Ethics, Dental Building, 1462 Clifton Road, Suite 302, Atlanta, GA 30322.
To better define the learning objectives of ethics curricula and evaluate changes in medical students' attitudes about end-of-life decision making, enrolled students (N=96) of a pilot medical ethics program were surveyed at the beginning and end of their third-year clinical clerkship about their experiences and attitudes about end-of-life decision making. At the end of their clinical clerkship year, the majority of students had participated in end-of-life decisions, prioritized patient autonomy and quality-of-life issues, were concerned about legal liability, were polarized over issues such as physician-assisted suicide, and gained confidence in their ethical decision-making ability. To train future physicians such that clinical practice is consistent with ethical guidelines and legislation on end-of-life care, medical ethics curricula should focus on symptom relief, clarification of legal issues, and resolution of conflicts between personal beliefs and public opinion about such issues as physician-assisted suicide. Appropriate role-modeling and mentoring by residents and attending physicians should also be emphasized.
Key Words: Ethics Education • End-of-Life Care • Medical Students
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