a kind of implied moral reasoning.
The leading Dutch journal of medicine,
the Nederlands Tijdschrift voor Geneeskunde,
is also more and more inclined to
discuss moral problems, for instance, in
the field of the care of the dying, although
ethical considerations are seldom made explicit.
The teaching of ethics to future physicians
is just starting in some of the seven
medical schools in the Netherlands. The
students enter the medical school immediately
after finishing secondary education,
at the age of eighteen. Basic medical education
takes six years. The final examination,
however, is not for licensing; to be
licensed for medical practice one has to
take additional training in one of the clinical
specialties or in general practice
In four of the seven medical schools
some teaching of ethics takes place. In
three of them the teacher is a theologian
who specialized in (philosophical) ethics.
In our country philosophers, in contrast to
theologians, are in general not very interested
in applied ethics.
The oldest and, some people say, most
important medical school of Leiden University
has just accepted ethics as a formal
part of the curriculum. An introduction
and a short examination in the first year are
followed in the later years by a more extensive
program and examination. The
teacher of ethics (only one has been hired)
also participates in all kinds of other
courses, especially in clinical teaching.
In the Leiden medical school of about
1,700 students and a faculty of 400 (including
medical staff) the only ethicist has
an almost impossible task. Yet it has been
possible to provide several courses (in the
first and other years), and also a three-hour
seminar, in groups of ten, for all students
in the fifth year. Furthermore, the students
are confronted with the contribution of ethics
at various points in the curriculum. Ethics
education can only be successful,
however, if the faculty recognizes ethics as
an important matter, and themselves refer
to moral problems in their courses. A very
important aim is, therefore, to teach the
teachers, not only for practical reasons
(because there are fewer of them compared
to the students), but more so for reasons of
principle.
Only half of all medical students in Holland
experience ethics teaching during
their medical education. The same is true
for other medical or paramedical professions:
some take ethics courses, others do