Appendix 51b - Ethical Erosion

by Michael Greger, MD and United Progressive Alumni

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From Harper's Magazine:

'I was once on killer call,' a resident on the West Coast told me, 'and had to tell a man he had terminal cancer. I gave him maybe three minutes of my time, checked him off my list, and headed off to do something else.' A few moments later, when the resident realized what he had done, he ducked into a supply room so no one would see him sobbing. 'I'd become a monster,' he told me afterward, 'and I hate myself.'[583]

The test of every religious, political, or educational system, is the man which it forms. If a system injures the intelligence it is bad. If it injures the character it is vicious, if it injures the conscience it is criminal - Henri Frederic Amiel

Quoting from the American Journal of Medicine, "The medical students' life of long hours, sleep deprivation, excessive responsibility, and dealing with unreflective and arrogant superiors inhibits the growth of compassion and empathy."[584] Medical students are told to treat patients as persons deserving of compassion, care and respect, yet they find they have no time and energy to do so.[585]

In an article "Why does Moral Reasoning Plateau During Medical School?" the authors hypothesize that instead what the students learn is, "how to survive in a threatening environment, how to please authority figures to avoid punishment, and how to avoid humiliation and loss of face."[586] Quoting from Pharos, "The suppressed pain in medical training, then, and its devouring of time, both interfere with moral vision. Medical students must set aside their own humanity to learn the science and technology of medicine."[587]

An article from Mother Jones describes how medical students learn how to view human beings as boring:

This parallels the likely conclusions of the first overall review of medical schools' curriculum in 50 years. Steven Muller, president of Johns Hopkins University and Hospital and chairman of the committee handling the review, said... that the panel's experts are concerned that 'total immersion' might be 'dehumanizing' and may lead to a 'fascination with technology that makes the device more important than the patients.'[588]

From Medicine as a Human Experience:

I stick to my assertion that the education of many, perhaps most, medical students is seriously flawed, that too often we wind up as narrow and dehumanized as the system which has trained us.[589]

Medical students risk being replaced by TS Eliot's "Hollow men... Stuffed men, leaning together, headpiece filled with straw."[590]

From the landmark 60's sociological study of medical school, Boys i