Respect for Beliefs
Medical students at Brown adhere to a wide range of sincerely held conscientious, ethical, religious, and philosophical beliefs. The patients with whom the medical students interact likewise reflect diverse value systems and traditions. The Alpert Medical School recognizes and respects the beliefs, values and traditions of patients, health care providers, and medical students.
A Position of Mutual Trust
Medical students are required to learn about their patients’ particular values, traditions, and beliefs as these relate to the care and treatment options available to the patient. Neither the physician nor the patient is expected to violate his or her sincerely held moral beliefs. The goal here is sensitivity and respect necessary to develop mutual trust between the patient and medical student and to develop an effective physician–patient relationship. The oath that Brown students take upon becoming a physician articulates this kind of trust: “The health and dignity of my patient will ever be my first concern. I will not permit consideration of race, gender, sexual preference, religion, nationality, or social standing to come between me and my duty to anyone in need of my services.”
When Patients Question Students
When a patient asks the medical student’s opinion or advice about a concern or problem, the student should explore with the patient the basis for the question with the goal of providing accurate information, clarification, and support.
When Values Conflict and cannot be Resolved
In the case of an irresolvable disparity between the ethical beliefs and values of the medical student and the patient, the medical student needs to avoid argument, judgment of the patient’s personal integrity, or any action that would cause the patient to avoid seeking appropriate medical treatment and care. The student should seek to understand the patient's value system. The sensitive medical student avoids making assumptions based on stereotypes or preconceived ideas, and asks questions of patients about their beliefs, values, and lifestyle in a respectful, open, and empathetic manner. The medical student’s role is to explain the options available to the patient thoroughly and objectively, giving appropriate time and emphasis to each option while sensitive to the patient's value system. Should a patient wish to pursue an option of treatment or care that the student cannot carry out or arrange because of the student's own beliefs and values, the student must discuss the situation with his/her supervisor to assure appropriate follow-up.
A medical student may decline to participate in or perform procedures that are in direct conflict with the student's own beliefs and values. When this situation arises, the student must discuss his/her concerns and intentions with the supervisor. Faculty should not allow the student’s decision to adversely affect the student's performance appraisals, grades, or other privileges generally afforded to medical students. When there is a compelling reason that otherwise mandates the student’s involvement, the supervisor is to make this clear while being respectful of the student’s beliefs. Students and faculty are encouraged to discuss their values and beliefs when it can be anticipated that conflicts may occur, and avoid placing patients in potentially difficult and embarrassing situations. The Associate Dean for Medical Education will hear concerns of students and faculty about unresolved situations and take appropriate action to achieve mediation and reconciliation.
Refusal to participate in a procedure or practice does not excuse the medical student from being knowledgeable about that procedure or practice in question, or from informing a patient about that procedure as one option among others. Faculty may include questions designed to ascertain students' knowledge about such procedures on examinations. Students may not decline to answer these questions on the grounds of their sincerely held beliefs. They may, however, refuse to perform such procedures even if they are included in a performance-based evaluation. The student and the faculty should discuss alternative ways to assess essential knowledge or skills that the examination seeks to measure. The Associate Dean for Medical Education may be consulted to aid this process, and the Dean is to be consulted if the student and the faculty member cannot reach an agreement.
Class Excuse for Religious Observance
Medical students are to be excused from class exercises when they conflict with religious holidays. To the extent feasible, the medical school will try to avoid scheduling classes in a way that they consistently fall on holidays of any religious group. However, such avoidance is not always possible or practical. The medical school will in those cases make reasonable accommodation for students. Students should contact their professors well in advance of their anticipated absence to make alternative arrangements. This applies to classroom exercises, laboratory assignments, and hospital clinical assignments.
Honoring Free Speech and Setting Standard
The medical school recognizes the diverse beliefs and values among its students (including those who are nonreligious) and strives to avoid statements and actions that may offend or disparage any student or faculty member. This position does not diminish the rights of free speech of faculty, administrators, or students; rather it sets a standard for respectful dialogue and action. All members of the medical school community will be guided by mutual concern for each other's dignity, integrity, needs, and feelings. This tenet demands sensitivity and responsibility. For further information consult the Principles of the Brown University Community (see Section VII or http://www.brown.edu/Student_Services/Office_of_Student_Life/judicial_af...).
Committee on Multiculturalism, September 28, 1995 Approved by the Biomedical Faculty Council, October 25, 1995