Medical ethics education is integral to the mission of the Division of Medical Ethics, and all faculty members are involved in our educational initiatives. Led by Division Chief, Joseph J. Fins, M.D., M.A.C.P. the Division is responsible for teaching the medical ethics courses that are required for all students at Weill Cornell Medicine in the longitudinal curriculum. The Division is also responsible for overseeing medical ethics case consultation at the New York Presbyterian Weill Cornell Medical Center and students may have exposure to these cases during their clerkships, clinical rotations and sub-internship experience. In the first year, Inmaculada de Melo-Martin, Ph.D. directs the ethics content is EPOM. Samantha Knowlton, M.D., M.S. is responsible for course content in HID I and II. Ellen Meltzer, M.D., M.S., F.A.C.P. is responsible for ACE and TTR in the third and fourth years. The Division is also represented at the Doha, Qatar campus of WCM by Pablo Rodriguez del Pozo, M.D., J.D., Ph.D. In addition, its research seminars are available to faculty, students, and trainees.
Medicine is infused with ethical values. What is thought to be appropriate or inappropriate clinical care depends not only on medical facts but also on ethical norms. Moreover, medical practice shapes not only people’s health but also crucial aspects of human life such as our understanding of death, what counts as a normal or disable body, or what the reproductive rights entail. The longitudinal ethics curriculum seeks to develop students’ understanding of ethical principles, values, and norms as relevant to the practice of medicine and to medical professionalism, promote their ability to recognize and address ethical challenges arising in medical practice at the individual and the social level, foster students’ habits of critical thinking, and nurture their personal integrity and self-awareness.
Medical Ethics in Essential Principles of Medicine (EPOM), Fall Year 1
This introductory course in medical ethics for first year medical students provides an account of the importance of ethical reflection and understanding for medical professionalism. The main purpose of these sessions is to explore the special moral duties that healthcare professionals have to patients and society. The course discusses the nature of such moral duties, what those duties are, what they entail, and potential conflicts between duties. It also explores how personal bias can interfere with the fulfillment of these professional obligations and the negatively effects on patients and society of such failures. Lecture topics include: The Hippocratic Oath; the History of Medical Ethics and Medicine; Physicians’ obligation to patients, colleagues, and society; and Conscientious Objection. This course mobilizes approximately 20 faculty members and hospital staff who both lecture and serve as faculty leaders for interactive, small-group discussions.
Course Director: Inmaculada de Melo-Martín, Ph.D., M.S.
Medical Ethics in Human Illness & Disease (HID I & HID II), Spring Year 1 & Fall Year 2
Also taught by the Division of Medical Ethics, the goal of this course is to teach students to recognize the importance of rigorous ethical analysis when making clinical decisions. The course provides foundational knowledge of important ethical concepts, and explores various ethical challenges that arise in different areas of medical practice, and discusses the ways in which individual and structural biases contribute to promoting injustice in medical practice. Topics include: The Case of Dax: Respect for Autonomy; Informed Consent/Refusal; Surrogate Decision Making; Research Ethics; Ethics in Pediatrics; Reproductive Ethics; Neuroethics; Ethics and Disabilities; and Ethics at the End of Life. This course mobilizes approximately 30 faculty members and hospital staff who both lecture and serve as faculty leaders for interactive, small-group discussions.
Course Director: Samantha Knowlton, M.D., M.S.
Advanced Clinical Ethics (ACE), Spring Year 3
This required third-year course, taught immediately following third-year clerkships during the 4-month Area Of Concentration (AOC) block, is designed to promote self-reflective practice and develop competencies in clinical ethics and end-of-life care. The main goal of this skills-based course is to help students to identify and analyze ethical challenges in clinical care, particularly in relation to respect for autonomy. ACE topics include: the Right to Withhold and Withdraw Life-Sustaining Treatment; Futility Disputes; Organ Donation; Ethical challenges during Pregnancy; Decision-making in Pediatrics; and Palliative Care. This course mobilizes approximately 35 faculty members and hospital staff who both lecture and serve as faculty leaders for interactive, small-group skill building sessions.
Course Director: Ellen C. Meltzer, M.D., M.Sc., F.A.C.P.
Medical Ethics in Transition to Residency (TTR), Spring Year 4
This required fourth-year course is taught immediately prior to graduation and the start of internship. The goal is to prepare students to identify and address ethical challenges that they will commonly face during their training. Through simulations, students will learn about the importance of communicating with patients and surrogates in empathic and culturally sensitive ways, the significance of nurturing trust, and the relevance of reflecting on personal bias, attitudes, and experiences that negatively affect the doctor-patient relationship. Topics include: Medical Error Disclosure, The Delivery of Bad News, and End-of-Life Decision Making.
Course Director: Ellen C. Meltzer, M.D., M.Sc., F.A.C.P.
Medical Ethics Education at Weill Cornell Medical College in Qatar
Pablo Rodríguez del Pozo, M.D., J.D., Ph.D., Associate Professor of Medical Ethics, represents the Medical Ethics Division at the Doha, Qatar campus of Weill Cornell Medical College. In close consultation with colleagues in New York, he directs the entire Medical Ethics curriculum at that campus for both medical and pre-medical students, Dr. Rodríguez del Pozo and Dr. Fins co-authored the first publication from the medical college branch, “The Globalization of Education in Medical Ethics and Humanities: Evolving Pedagogy at Weill Cornell Medical College in Qatar” (Academic Medicine, Vol. 80, No. 2/February 2005), which discusses their experiences in implementing a Medical Ethics and Humanities course for premedical students. Drs. Rodríguez del Pozo and Fins and are also co-editors of a new section of Cambridge Quarterly of Healthcare Ethics, entitled “Spanish Bioethics”. Dr. del Pozo’s current research interests are focused on disability, rights and health care. The January 2018 issue of a mainstream European Human Rights Journal is entirely dedicated to the outcomes of his research on disability in Qatar.
Dr. Rodríguez del Pozo’s innovative educational initiatives have included organizing and moderating debates on current controversial health topics for second-year pre-medical students in the Medical Ethics and the Humanities course. In 2006, the students argued for and against the motion: “This House believes that Terry Schiavo had the right to die by having her feeding tube removed”. The topic for the second debate, held in February 2007, was whether or not medical drugs that enhance mood and cognition should be made available over the counter. Dr. Rodríguez del Pozo has vigorously promoted these debates as an important way to foster academic and civic values.
Currently, a rotation in Medical Ethics for fourth-year medical students is being developed to match WCM’s new curriculum in Qatar.
A Revised Hippocratic Oath
At the request of Dean Antonio M. Gotto, Jr., M.D., D.Phil. (now Dean Emeritus), Dr. Fins chaired a special committee of 18 faculty and two student leaders from both the New York City and Doha, Qatar campuses of Weill Cornell Medical College to craft an updated version of the Hippocratic Oath. The committee was composed of a diverse and distinguished group including Dean Gotto, Carol L. Storey-Johnson, M.D., Senior Associate Dean for Education, Alvin I. Mushlin, M.D., Sc.M., Chairman of the Department of Public Health; Pablo Rodriguez del Pozo, M.D., J.D., Ph.D., Assistant Professor of Public Health - Qatar; Donna DiMichele, M.D., Associate Professor of Public Health, Oliver Fein, M.D., Professor of Clinical Public Health, and The Reverend Curtis Hart, M.Div., Lecturer in Public Health. The new oath was unveiled at Commencement ceremonies in June 2005.
The original Hippocratic Oath has been revised many times to reflect changes in medical practice. Historically, these revisions have been undertaken by individuals or professional associations. The new Weill Cornell Medicine oath is distinctive because it represents an institutional effort. New emphases in the revised oath address the doctor’s responsibilities and duties to serve as advocate for their patients, champion social justice for the sick, and forge strong bonds throughout the healing process. It also fosters trust and respect within the profession by including a pledge to help sustain colleagues in their service to humanity. The committee worked to achieve a balance between archaic and modern forms of expression and also replaced phrases that have a religious connotation with more ecumenical expressions.
The revised oath ends on a more positive note than the classical version, which threatens retribution for any doctor who transgressed the oath and swore falsely. Revised, it reads: “I now turn to my calling, promising to preserve its finest traditions, with the reward of a long experience in the joy of healing.” It concludes: “I make this vow freely and upon my honor,” again underscoring personal responsibility as a guidepost in one’s profession.
Read the full press release here.
The oath has also been printed on the back of t-shirts being sold at the Weill Cornell Medical College bookstore.