Tuesday, May 13, 2008

Giving Ethics Education a Bad Name

Three months ago I described "A Ridiculous Use of Medical Ethics Teaching" - a case where a recurrent offender was "sentenced" to ethics education in response to continued bad practice.

Today's Washington Post gives another example of the same phenomenon. A Rockville pediatric dentist, Dr. Ophir Alalouf, had his license suspended for performing "extensive dental treatment without clinical justification," at times without authorization from parents.

Dr. Alalouf agreed to a one year suspension of his license. What stuck me is this detail - if he completes a series of courses and exams, the suspension will be shortened.

Everyone in my entire immediate family is involved with education. Education matters. But not as an enforcement policy to correct a pattern of unethical action. This is a 19th century view - that contemplating scripture, whether in penitentiaries or insane asylums - would tame the savage beast of errant action. (David Rothman's "The Discovery of the Asylum" tells this story well.)

If we continue the fantasy that sitting in ethics class will "cure" recurrent violations by mature clinicians we will give ethics education a bad name and fail in our responsibility to protect the public.