On the integration of Ethics into the Physiology curriculum

Abstract

In moments of grief, human beings seek solace and attempt to discover the meaning of life and death by reaching out to wider and deeper dimensions of existence that stem from their religious, cultural and spiritual beliefs. Conventional patient care fails to consider this vital aspect of our lives. Many hold the view that life and its experiences do not end with death; the body is but a sheath which holds the soul that inhabits it. The use of a protocol-based practice to create a solemn atmosphere around the departed individual can bridge the gap between the materialistic and non-materialistic perceptions of the dimensions of care. The innovative practice, "Code Krishna", is aimed at institutionalising a practice which sensitises and empowers the treating team to address the grief of the relatives of deceased patients, and respect the departed in consonance with the family's cultural, religious and spiritual beliefs. The practice entails the creation of a solemn atmosphere amidst the action-packed environment of the critical care unit at the time of the patient's death, offering of collective prayer and floral tributes, and observation of silence both by the healthcare team and family members. Code Krishna attempts to blend current care practices with spirituality, ensuring that the treating team is the first to commiserate with the grieving family, with warmth and openness. In this piece, we briefly report our first-hand experiences of practising Code Krishna in our hospital [Shree Krishna Hospital, Karamsad, Central Gujarat].

Integrating Ethics into the Physiology curriculum: a scale-up study in three medical colleges in Karnataka, South India

“…Following the pilot study conducted by College A (7), an invitation to participate in a scale-up study was extended to various colleges from all over the state in the workshop that followed (22). The scale-up study was conducted with the two colleges that responded favourably.…”

“…One college was a private Catholic-minority institution under the State Medical University with formal separate classes on ethics for undergraduate students conducted by the Medical Ethics department functional for several years, the second college was a private institution from the same State Medical University the students had no exposure to sessions on Ethics and the third was a private medical college under a different deemed university not conducting any course in Ethics. The methodological limitation of non-inclusion of a government medical college, despite the investigators' efforts due to constraints and challenges of implementation needs to be mentioned (22). The admission process for the academic year 2016-17 was similar across the three colleges through the National Eligibility Entrance Test (NEET), which is the common medical entrance test throughout the state.…”

“…Further, no government medical college was included in the study, as the faculty attending the workshop from these colleges hesitated to volunteer although they were personally interested. The reason mentioned by these faculty members for not participating in the project was "Possible lack of buy-in from the faculty within a department and from the managements of institutions, both private and especially government, since the MCI has still not mandated such integration" as shared by them during the workshop (22). The use of a semistructured questionnaire for the student feedback without a formal qualitative component does not allow us to explain the findings fully.…”

“…They recognised the need to take ethical issues into consideration from the beginning of medical training and through future years. A state-level workshop was organised for physiologists with the aim of disseminating the idea of the pilot programme and identifying the challenges faced across various medical college settings (22). As an outcome of the workshop, two other medical colleges from the state (coded as College B, College C) collaborated with College A to introduce the programme at their institutions.…”

An Exploration of Medical Education in Central and Southern China: Measuring the Professional Competence of Clinical Undergraduates

“…Additionally, many scholars have assessed a certain dimension of the professional competence of students, such as the professionalism of medical students [18,19,20], communication skills [21,22], and medical ethics [23,24], instead of comprehensive competence. Furthermore, although some scholars have assessed the comprehensive competence of medical professionals such as physicians [25,26] and nurses [27], few studies focused on the comprehensive competence of medical undergraduates.…”