Radiol Oncol 2000; 34(3): 3078.
Advanced course on ethics in oncology
June 25-28, 2000, Bled, Slovenia
An Advanced Course on Ethics in Oncology was held from 25th to 28th of June 2000 in Bled, Slovenia. The course was organized by the Institute of Oncology from Ljubljana, Slovenia and sponsored by the European School of Oncology. It was carried out under the high patronage of the first lady of Slovenia Mrs. Štefka Kučan. 57 participants from 15 different countries attended the course, most of them from Slovenia and Eastern Europe.
The course was exceptional in many ways, one of them certainly being the beautiful setting of Lake Bled and Grand Hotel Toplice, where the course was held. Its topic, biomedical ethics, has an increasingly important role in medicine, not only in Western Europe and in the USA but also in the Eastern Europe, where most of the course participants came from. For many of them, the course offered the first formal teaching on the subject, as well as a unique chance of debating ethical issues with distinguished invited speakers. Among the course's invited speakers were prominent international authorities in the field of biomedical ethics: Prof. Matjaž Zwitter from the Institute of Oncology, Chairman of the organizing committee and co-author of the book Communication with the Cancer Patient - Information and Truth, Prof. Raanan Gillon, Editor of the Journal of Medical Ethics and Senior Editor and coauthor of the textbook Principles of Healthcare Ethics, Prof. Povl Riis, co-author of the Second Declaration of Helsinki and an expert on ethical issues in biomedical research, Georges B. Kutukdjian, Senior Director of the Division of the Ethics of Science and Technology at UNESCO, Mgr. Charles G. Vella, Member of the Ethics Committee of the Cambridge Journal of
Bioethics and author of a number of books on family, counseling and ethics, Prof. Tore Nilstun, Vice-Chairman of Research Ethics Committee at IARC and of Clinical Ethics Committee at Lund University Hospital, Prof. Jože Trontelj, Chairman of Slovenian National Medical Ethics Committee and coauthor of the Oviedo Convention, Nora Kearney, Senior Lecturer in Cancer Nursing at the University of Glasgow and immediate past President of the European Oncology Nursing Society, Prof. Gregory L. Larkin, author of many publications on ethical issues, including the Code of Ethics for Emergency Physicians, and others.
The course did not or better could not cover only the ethical issues within oncology. In the brief and thorough introduction to medical ethics by Prof. Gillon and Mgr. Vella we learned about the four basic principles of medical ethics, respect for autonomy, beneficence, non-maleficence and justice, and their implementation in medical practice. The course continued with more detailed lectures about the ethical principle of autonomy in medical practice, ethics of clinical research, dying and euthanasia, and medical utility (the ethical principle of justice in the face of scarce medical resources). Some of the lectures included cases illustrating some common ethical dilemmas clinicians encounter in their daily practice. Each lecture was followed by ample amount of tirne for discussion, which is the most important instrument in teaching bioethics. As most of the lecturers actively practice medicine, they could provide practical and useful insights as well as academical answers to our questions and dilemmas. The best part of the course was therefore the round table discussion that took place on the third day. By that tirne, informal and
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friendly atmosphere of the course was already established and enabled an open and lively discussion on ethical topics that participants pointed out as most problematic. We talked about inappropriate prolongation of life, patients' false hopes in connection with new treatments and problems in informing the patient about the prognosis of incurable cancer. We all agreed that doctor-patient relationship is based upon and can be improved by physician's knowledge of medical ethics and good communication skills. Both these topics are insufficiently taught to medical students, especially in the Eastern European countries.
Social program of the course was not as abundant as the lectures, but it helped to establish an informal and friendly atmosphere. The ice was certainly broken by a rowing regatta to the Island of Bled, where some of us more or less successfully tried to make the lucky bell ring. The gala dinner, which was held in the romantic Bled Castle, was
enriched by a special „main course", the dinner talk by Prof. Borut Telban from Slovenian Academy of Sciences and Arts. Prof. Telban is an anthropologist who spent three years doing research among the tribes in the Papua New Guinea. He gave us an account on human values in those communities, which is a unique perspective not many of us will ever have a chance to experience.
As this was the first international course on biomedical ethics in oncology and in this geographical area, it answered some but opened many new questions about this important topic. The participants stated that the course fulfilled their expectations and agreed that courses on biomedical ethics are much needed and will therefore have to be repeated, preferably including a more practical approach, based on case reports and enabling a guided discussion about concrete ethical dilemmas.
Patricija Ecimovic
Radiol Oncol 2000; 34(3): 307-8.