Theoretical Medicine

, Volume 15, Issue 1, pp 39–52 | Cite as

A methodology for teaching ethics in the clinical setting: A clinical handbook for medical ethics

  • Laurence B. McCullough
  • Carol M. Ashton


The pluralism of methodologies and severe time constraints pose important challenges to pedagogy in clinical ethics. We designed a step-by-step student handbook to operate within such constraints and to respect the methodological pluralism of bioethics and clinical ethics. The handbook comprises six steps: Step 1: What are the facts of the case?; Step 2: What are your obligations to your patient?; Step 3: What are your obligations to third parties to your relationship with the patient?; Step 4: Do your obligations converge or conflict?; Step 5: What is the strongest objection that could be made to the identification of convergence in step 4 or the arguments in step 4? How can this objection be effectively countered?; and Step 6: How could the ethical conflict, or perceived ethical conflict, have been prevented?

Key words

bioethics clinical ethics teaching handbook preventive ethics 


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  1. 1.
    Aristotle.Nichomachean Ethics, in Jonathan Barnes (ed.),The Complete Works of Aristotle. Princeton: Princeton University Press, 1984.Google Scholar
  2. 2.
    Rest JR. A psychologist looks at the teaching of ethics.Hastings Center Report 1983; 13: 29–30.Google Scholar
  3. 3.
    Beauchamp TL and McCullough LB.Medical Ethics: The Moral Responsibilities of Physicians. Englewood Cliffs, NJ: Prentice-Hall, Inc, 1984.Google Scholar
  4. 4.
    Morreim EH.Balancing Act: The New Medical Ethics of Medicine's New Economics. Dordrecht, The Netherlands: Kluwer Academic Publishers, 1992.Google Scholar
  5. 5.
    Thomasma DC. Training in medical ethics: An ethical workup.Forum on Medicine 1978; 1: 33–36.Google Scholar
  6. 6.
    McCullough, LB. Addressing ethics dilemmas: An ethics work-up.The New Physician 1984; 33: 34–35.Google Scholar

Copyright information

© Kluwer Academic Publishers 1994

Authors and Affiliations

  • Laurence B. McCullough
    • 1
    • 3
  • Carol M. Ashton
    • 2
    • 3
  1. 1.Center for Ethics, Medicine, and Public IssuesBaylor College of MedicineHoustonUSA
  2. 2.Quality of Care and Utilization Studies, A V.A. Health Services Research and Development Field ProgramHouston Veterans Affairs Medical CenterHoustonUSA
  3. 3.Department of MedicineBaylor College of MedicineUSA

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