The teaching of medical ethics in the United States of America.

Historically, the United States has had a long tradition of medical ethics teaching but not in the sense in which the term is applied today. Traditionally, teaching institutions sponsored by religious denominations primarily Roman Catholic and Jewish have included the study of ethical problems in medicine in their medical, as well as in their other, educational efforts. Seminary students and other professionals were taught the medical ethical tradition of their particular religious group. Even the secular medical school curriculum included courses called 'medical ethics', but they were devoted to what might more appropriately be labelled 'medical etiquette'. Questions such as fee splitting, advertising, the size of one's signs, and relations with osteopaths, chiropractors, and even quacks were major subjects of debate. Medical students were socialized into their new role, having been taught the merits and methods of conducting proper relations with their professors, their colleagues, and, ultimately, their patients. Over the past decade, there has been a dramatic change. New medical techniques have forced people physicians and lay people to face almost daily dilemmas they could not fail to recognize as ethical. Many medical schools have begun to develop new teaching programmes, responding to the challenge of educating the new generation of physicians to deal with a newer, larger group of more public ethical problems in medicine. A rebellion against the excessive technological development of medicine, focusing on the scientific aspects of medicine at the expense of the more humanitarian, has led to a widespread outcry for revised training of physicians. These same forces have led to an explosion of medical ethics teaching designed for lay people and non-medical professionals, as well as nurses, public health workers, and others in the health care professions. Lawyers, clergymen, teachers, and more generally undergraduate students with no professional use for medical ethics instruction may now have a medical ethics course as part of their education. In I973 a National Commission on the Teaching of Medical Ethics began a three-year investigation of the present state and future potential of teaching medical ethics in the United States. The Commission, generated by the Education Program of the