Beyond the hidden curriculum: The challenging search for authentic values in medical ethics education

Abstract

Since the practice of medicine is a moral enterprise, medical ethics education aims to produce ‘good’ doctors who are capable of self-reflective discernment of the many values at play in the clinical encounter, and of re-affirming the patient’s human dignity. However, the caring and compassionate physician envisaged as the end-product of medical ethics curricula evidently remains elusive. I argue that this apparent failure of medical ethics education is traceable to a systematic de-emphasis of humanistic values since the pioneering stages of formal medical ethics curricula. The idea of ‘the hidden curriculum’ connotes a distinctive value-laden medical morality that is transmissible through socialisation and role-modelling in the medical school moral ecosystem. Further, the hidden curriculum is hampered by the challenging medical school workload, bad role models, and lack of appropriate evaluation and assessment methods, as well as the lack of consensus in bioethics on the key concept of human dignity. Properly conceived, the dignity of the human person is the ultimate source of human values. Optimising the hidden curriculum, therefore, demands an authentic and comprehensive enquiry into the concept of human dignity, as well as the nature of the human person, the true human good and what constitutes the unitary good of the patient.