Medical students' affirmation of ethics education.

OBJECTIVE: Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula. METHODS: Eighty-three medical students at the University of New Mexico participated in a self-administered written survey including 41 scaled questions regarding attitudes, needs, and preferences toward medical ethics and ethics education. RESULTS: Students reported strong personal interest in learning more about ethics in clinical medicine and research. They most strongly endorsed as valid objectives of ethics education the goals of helping professionals "better recognize ethical issues and clarify values-laden choices," "improve patient care and clinical decision-making," and "improve ethical practices in clinical research." Participants strongly agreed that "professional attitudes and values are an appropriate focus for medical education" and also expressed strong interest in learning more about specific ethical topics and learning methods. Women more strongly endorsed interest in additional ethics education and a preference for increased ethics education than men. Preclinical participants expressed a greater desire for additional training on all ethics topics than clinical students. CONCLUSION: The medical students surveyed strongly affirmed ethics education in medical school and expressed clear preferences for curricular topics and teaching methods.

Nonpsychotic, nonparaphilic self-amputation and the internet.

The literature suggests that self-amputation is an outgrowth of either psychosis or paraphilia. In the case we present, the patient was neither psychotic at the time of amputation, nor did he ascribe a sexual motivation for his act. Instead, he had a long-standing idea that being an amputee was a critical aspect of his identity. The patient used the internet to research the method for his amputation and sought support from individuals with the same desire via e-mail, web sites, and Usenet news groups.

Maintenance ECT for recurrent medication-refractory mania.

Maintenance electroconvulsive therapy (ECT) can sometimes be the only treatment that yields extended periods of euthymia to patients with severe, treatment-resistant mania. We describe a case of a patient with recurrent and severe mania who responded acutely to ECT after failing various medication trials and could only maintain euthymia with maintenance ECT.