THE STATUS OF ETHICS EDUCATION IN OBSTETRICS AND GYNECOLOGY

To establish the present status of ethics education in obstetrics and gynecology, 256 questionnaires were sent to residency (graduate) and s tudent (undergraduate) education programs. One hundred ninety-eight qu estionnaires were returned. Fifteen programs offered no ethics educati on; 167 offered resident level courses; 123 offered undergraduate (stu dent) level courses; and 84 offered postgraduate education. The median number of hours offered was 2 undergraduate, 4 graduate, and 2 postgr aduate. The courses offered relied primarily on formal lecture present ation, even though this was not considered most effective by the respo ndents. Most institutions (85%) used more than one format to present e thics material. General ethics principles were covered in 78% of the r eporting institutions. Where ethics case histories were used, they wer e rated higher in efficacy by the respondents. Only 15% of the reporti ng institutions had any means of measuring outcomes. The issues cited most frequently as critical in a curriculum were abortion, maternal-fe tal conflicts, issues surrounding care decisions at the end of life, a nd informed consent. The few hours dedicated to ethics were small rela tive to a long list of issues. Obstetric-gynecologic faculty with any training in medical ethics were uncommon (29%). The form of teaching, except in rare circumstances, seemed to lack structure or design and u sed few of the available reading materials. Recommendations from this survey include the development of a uniform national curriculum for un dergraduate and graduate medical ethics, development of evaluation alt ernatives for ethics education, and encouragement and support for facu lty development in medical ethics.