Ethics - (not) a topic in the emergency and intensive care training of medical students?

Medical assistance in emergency and intensive care is subject to multiple challenges and bound to various normative conditionalities. Decision-making takes place in situations of urgency in often complex social situations. It is symptom oriented with usually little anamnestic details to draw on, and has to include important moral, legal and socio-political values, goals and rules [5]. Universal access to emergency care is an important common good. Against this background, physicians have to be able to come to well-founded decisions based on medical guidelines and ethics, including professional principles of decision-making and conduct. However, ethical aspects do not play a significant role in training and education of health professionals for emergency care as yet [11]. At the same time, emergency medicine and intensive care offer unique opportunities for educators to include ethics into the clinical training of medical students and health professionals in general. The Department of Anaesthesiology and Operative Intensive Care Medicine of the University Hospital of Giessen along with the Giessen Working Group on Ethics in Medicine and the Dean of Medical Education of Giessen University Medical School decided to close the gap between the importance and the real offer of clinically related training of medical ethics during the clinical years of medical education (3rd to 5th year). A new course element was developed to address ethics within the compulsory training of medical students in emergency and intensive care, based on the "Ulm model" of interactive, case-based seminars in medical ethics [4,7,8]. This article introduces the concept of the course, which has been successfully implemented in 2011. Our evaluation of the first experiences over a period of eight semesters shows that the concept has been received and assessed very positively by the students. This approach to include ethics in clinical training may also be suited to be applied in other clinical disciplines as well as for transfer to other universities and medical schools.