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Logo of jmedethJournal of Medical EthicsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Med Ethics. 2000 December; 26(6): 462–465.
PMCID: PMC1733313

An ethical paradox: the effect of unethical conduct on medical students' values


Objective—To report the ethical development of medical students across four years of education at one medical school.

Design and setting—A questionnaire was distributed to all four classes at the Wake Forest University School of Medicine during the Spring of 1996.

Participants—Three hundred and three students provided demographic information as well as information concerning their ethical development both as current medical students and future interns.

Main measurements—Results were analyzed using cross-tabulations, correlations, and analysis of variance.

Results—Results suggested that the observation of and participation in unethical conduct1 may have disparaging effects on medical students' codes of ethics with 35% of the total sample (24% of first years rising to 55% of fourth years) stating that derogatory comments made by residents/attendings, either in the patient's presence or absence, were "sometimes" or "often" appropriate. However, approximately 70% of the sample contended that their personal code of ethics had not changed since beginning medical school and would not change as a resident.

Conclusions—Results may represent an internal struggle that detracts from the medical school experience, both as a person and as a doctor. Our goal as educators is to alter the educational environment so that acceptance of such behaviour is not considered part of becoming a physician.

Key Words: Ethics • ethical development • paradox • medical students • derogatory comments

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