Changing attitudes about end-of-life decision making of medical students during third-year clinical clerkships

To better define the learning objectives of ethics curricula and evaluate c hanges in medical students' attitudes about end-of-life decision making, en rolled students (N = 96) of a pilot medical ethics program Mere surveyed at the beginning and end of their third-year clinical clerkship about their e xperiences and attitudes about end-of-life decision making. At the end of t heir clinical clerkship year the majority of students had participated in e nd-of-life decisions, prioritized patient autonomy and quality-of-life issu es, were concerned about legal liability were polarized over issues such as physician-assisted suicide, and gained confidence in their ethical decisio n-making ability To train future physicians such that clinical practice is consistent with ethical guidelines and legislation on end-of-life care, med ical ethics curricula should focus on symptom relief clarification of legal issues, and resolution of conflicts between personal beliefs and public op inion about such issues as physician-assisted suicide. Appropriate role-mod eling and mentoring by residents and attending physicians should also be em phasized.