Ethics-in-oncology forums

We developed an ethics curriculum for hematology/oncology fellows who had already learned medical ethics from medical school and residency programs. The goal of the ethics program was to train fellows in ethics issues specific to hematology/oncology; to raise awareness of ethical issues; and to teach fellows to write, edit, and publish reviews in specific ethical issues.

Fellows learned to summarize expert opinions, to understand diversity in cultural concepts relating to ethics, and to crystallize their approaches to ethical dilemmas to selected oncology patients. Fellows were also trained to write ethics discussions in manuscript format, edit the manuscripts, and submit them for publication.

We hypothesized that fellows would learn ethics in oncology by recognizing and choosing an ethical dilemma from among patient population; reviewing the literature for a discussion of relevant ethical issues; presenting the case and facilitating discussion to an ethics-in-oncology committee; hearing faculty and peer input into their cases; and finally writing, editing, and publishing the deliberation. It also increased understanding of health systems management, a new competency required by the Accreditation Council for Graduate Medical Education for board certification.

Fellows' perceptions about the experience were positive. We recommend that other subspecialty programs consider this format for teaching ethics in their subspecialties.