Why does “Ethics” need to be taught?

It probably seems obvious that we should all strive to “do the right thing,” so why is a formal ethics education necessary? There are two main reasons. The first is that although doing “the right thing” is clearly important, it often isn’t easy. Ethics aside for a moment, simply think about your own life; do you always do all the “right things” every day? If so, congratulations, you’re the rare exception! Most people try to eat healthy, but then end up indulging in yummy junk foods or convenient overly processed foods. Most people recognize the importance of regular activity and exercise, but then find it hard to commit to a regular workout routine. Most people want to be successful in the future, but then they end up procrastinating on important work or spending more money than they can save. It’s one thing to be able to identify the “right thing to do,” but it’s another thing to put this into practice regularly.

The second reason is that it can also be challenging to even identify what “the right thing” is sometimes, especially in novel or morally complex situations. For example, we can ask big questions such as:

• “Do we have an obligation to help everyone equally, or do we have unique obligations toward certain individuals?“
• “Do we have an obligation to disclose every piece of information possible when being honest with someone, or is it acceptable to only provide certain information so long as it is truthful?“
• “How do we handle situations where people seem to be making bad decisions; should we respect their right to make their own decisions or should we step in to stop them if it will make the situation better?“

These questions don’t have obvious answers, and the answers may even depend on the specific context in which the question is being asked. Additionally, sometimes “the right thing” feels like the hardest thing or even “the wrong thing” initially, and this can make us question whether we’re really on the right path. The importance of a formal education is therefore to provide students with the tools to identify the “morally right action” in most situations, and then to provide them with regular practice working through challenging situations so that they can get comfortable making difficult decisions.

What is “Healthcare Ethics” about?

Over the years I’ve discovered that many students enroll in required “Healthcare Ethics” or “Medical Ethics” courses without really knowing what these courses are about. So what is “healthcare ethics” all about? Healthcare Ethics (or Medical Ethics) is a subset of a larger discipline called “Bioethics” which examines ethical challenges related to progress in the biosciences. Bioethics can be narrowly focused on “healthcare ethics” which is an examination of ethical issues that arise in medicine and healthcare, but bioethics can also more broadly include an examination of related topics such as animal and human research, genetic engineering, reproductive rights & technologies, end-of-life issues, resource allocation, public health, health law & health policy, and AI use in healthcare and scientific research. While these topics are each important and worth exploration, I’ve found that they are too much to pack into a single semester and best examined through the lens of a shared ethical framework, which is what this textbook endeavors to teach. So rather than providing a survey of topics in bioethics or even any arguments related to these topics, this textbook is narrowly focused on building out an ethical framework central to healthcare ethics, and this knowledge can then help students to think through these more advanced topics & issues in other courses. As such, this book is intended to provide a foundational introduction to fundamental concepts and ethical principles in bioethics while also providing a survey of ethical challenges in the more limited (yet still substantial) area of healthcare.

About the Textbook’s Structure

This textbook is most fundamentally an introduction to critical thinking in healthcare and is best used in an active-learning healthcare ethics or medical ethics course. Specifically, this textbook is written with a “flipped classroom” in mind, meaning the main content for each Module is presented upfront and intended to be read prior to the star of a module, followed by applied “Ethics Cases” and corresponding “In-Class Activities” (in the appendix) which challenge students to practice navigating and applying the content throughout the Module. Each Module should take approximately 2 weeks, with students working on one Ethics Case per class period, until the final Module which can take longer as students tie the previous Module concepts together in investigating an applied topic. The Ethics Cases and In-Class Activities can also work well to facilitate student collaborations, as students can be placed into “ethics committees” tasked with offering recommendations in each of the cases. And when these ethics committees stay consistent over time, meaning the same students are regularly working together, then students often become more comfortable sharing their thoughts with one another and asking questions, thereby facilitating quality student-to-student learning.