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Courses in medical ethics have become a routine part of the first or second-year medical school curriculum in the United States. However, some believe that the most important and meaningful educational opportunities related to the ethical aspects of medical or surgical practice occur during internship and residency. In fact, the Accreditation Council for Graduate Medical Education (ACGME) recognizes the need for exposure of residents to ethics education.1 A few training programs, such as Geriatrics and ObstetricdGynecology, provide formal education to enhance residents' knowledge of and experience in handling particular ethical issues that are likely to arise in their practices. Such programs acknowledge that the ethical aspects of their specialty are important enough to warrant formal attention during the busy residency years.
Diseases of the brain and nervous system provide neurologists with a particularly wide range of ethical challenges that require knowledge, sensitivity, and experience for successful resolution. The Ethics and Humanities Subcommittee of the American Academy of Neurology (AAN) undertook a survey of neurology training program directors in the United States to understand more about how they view ethics education as part of the neurology residency.
Methods and results of the survey
In the fall of 1991 the Subcommittee sent a 10-item questionnaire (table) to directors of neurology residency programs accredited by the ACGME. One hundred sixteen questionnaires were sent and 97 were returned (83.6%). As noted in this section when appropriate, not all respondents answered each question and some provided multiple answers to a single question. Fifty-eight of 97 respondents (59.7%) said that no formal instruction in ethics existed in their residency programs. Of the 39 (40.2%) reporting some education in ethics: none offered a formal course during the neurology residency, 79% used grand rounds, 36% held seminars or discussion groups, and 26% offered clinical rounds …
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