Using the History of Medical Ethics:Prof. G.W. Irwin, Teaching General

Practice &

Teaching Medical Ethics.

Nathan Emmerich

School of Sociology, Social Policy and Social Work

Queen’s University Belfast.

History of Medical Ethics & of Bioethics

The Codification of Medical Morality, Vols 1&2. Baker, Porter

John Gregory’s Medical Ethics, McCullough.

Disrupted Dialogue, Veatch

Strangers at the Bedside, Rothman

The Abuse of Casuistry, Jonsen & Toulimin

The New Medicine and the Old Ethics, Jonsen.

The Birth of Bioethics, Jonsen

Observing Bioethics, Fox & Swazey.

A History and Theory of Informed Consent, Faden & BeauchampThe Cambridge World History

of Medical Ethics, Baker & McCullough Bad Blood, Jones.

Contemporary History.

"[C]ontemporary history is different from what we know, in quality and content, from what we know as 'modern history‘” p.10.

"... some say the idea of contemporary history is a newfangled notion... it is not unfair to answer that what was newfangled was not a concept of history firmly anchored to the present but, on the contrary, the 19th Century notion of history as something dedicated entirely to the past.“ p.16.

"If we associate the concept of contemporary history with the onset of a new era [or ethos]... the term contemporary history is provisional and ambiguous.” p.20-21.

Barraclough: Introduction to Contemporary History. 1963.

Prof. G.W. Irwin & Academic General Practice

The 1970s: Getting going with “an idea whose time had come.”

“The development of academic General Practice should strengthen theory based on scientific principles. The emphasis in medical education should be on flexibility and integration … [G]eneral practice, in the functional sense, is a ‘specialty in breadth’”Irwin, Inaugural Lecture, given in 1971.

“[s]tudents, therefore, have to be taught communication skills, how to establish rapport, how to obtain information indirectly by enhanced perception and by cultivating the art of listening. They have to learn the basic skills of primary diagnosis, how to differentiate unselected primary illness with sometimes inadequate evidence and minimal diagnostic resources. They should be taught the responsibilities of decision making and management in primary care.”Irwin, Inaugural Lecture. 1971.

“There are many things that cannot be taught-other than by example. Lectures and even ward rounds cannot teach you the small courtesies, or rapport with the patients… We wish Prof. Irwin well, but hope that he will not lecture too much and will remember the words of Osler that ‘a true knowledge of medicine is learned at the bedside.’” Smiley, “Medical students and their education.,” The Ulster Medical Journal 44, no. 1 (1975): p.36.

Harland: Irwin’s “department ventured into the realms of educational theory in an unprecedented way.” PhD, QUB

1. GP Attachment2. Home Visits3. Small Group Learning4. One way mirrors5. CCTV

Before Teaching Medical Ethics.

“A new academic career structure in general practice in Northern Ireland.” The Journal of the RCGP 30, no. 221 (December 1980): 740–742.  

J.S. Perrott. “Systematic use of closed-circuit television in a general practice teaching unit.” The Journal of the RCGP 31, no. 230 (September 1981): 557–560.  

STOUT “Integrated medical student teaching. A combined course in community medicine, general practice, geriatric medicine and mental health.” Medical Education 16, no. 3 (1982): 143-146.

BAMBER. “The cognitive structure of the modified essay question.” Medical Education 16, no. 6 (1982): 326-331.  

“Striving to change.” The Journal of the Royal College of General Practitioners 32, no. 243 (October 1982): 593–606.  .

1982 and all that:

Willoughby Wilson: Old Ethics: New Dilemmas Annual Oration & UMJ

Campbell Moreland: Whose Choice? Whose Consent?Short Version, Published in the Lancet. Long Version Published by QUB in 1984. To be given to each graduating student.

Irwin joins the The Warnock Committee.

Beginning to Teach Medical Ethics.

Bamber. “An evaluation of medical student behaviours in communication.” Medical Education 18, no. 2 (1984): 90-95.  

Teaching terminal care at QUB. I&II: Course, Sessional Education Objective and Content. & Teaching arrangements and assessment of topic. BMJ (Clin. Res. Ed.) 288, no. 6457/8, 1894. (Dec 1): 1509–11 & 289, (Dec 8): 1604–05.  

“Current involvement of university departments of general practice in the final qualifying examinations of medical schools in the UK..” The Journal of the RCGP, 36, no. 282 (January 1986): 21–23.  

“Medical ethics.” The Ulster Medical Journal 56, no. 1 (April 1987): 1-12.  

McClelland, Stout, & Stchedroff. “Multidisciplinary teaching in a formal medical ethics course for clinical students.” JME 14, no. 3 (September 1988): 125-128.  

McClelland, & Love. “Communication skills training for medical students: an integrated approach.” Medical Education 23, no. 4 (1989): 387-394.

Using the History of Medical Ethics:

History or Sociology?

History of Ideas...

of Contemporary Ideas!

Social History of Medicine?

& of Medical Education

How do we do Historical Sociology?