How do we teach medical students to protect patients? My initial reaction to the question posed by Taylor and Goodwin was like first glimpsing ‘Jaws’: we’re going to need a bigger boat. The authors’ answer makes two important claims: first, that safety should be ethically sourced by better integration between teaching of safety and ethics; second, that teaching should encourage students to think about organisational failure rather than focusing on individual blame and personal responsibility to whistleblow.1 On the first, they (...) highlight how ethics teaching often sits apart from that on safety. For the second, they use the concept normalisation of deviance, with its contained idea of structural secrecy, to depict organisational failure that is argued as largely immune to whistleblowing. Why wouldn’t these challenges warrant a bigger boat? On their first claim: it is not just for safety, but throughout the curriculum that ethics teaching needs to be integral. Given coming challenges, it should become the cake rather than the icing. Consider, for example, that artificial intelligence stands to transform many knowledge-based professions, medicine among them. Tomorrow’s doctors will have a surfeit of data and automated decision aids at their fingertips. So, as far as they remain necessary, doctors will …. (shrink)

In the paper “An archeology of corruption in medicine”, Miles Little, Wendy Lipworth, and Ian Kerridge present an account of corruption and describe its prevalent forms in medicine. In presenting an individual-focused account of corruption found within “social entities”, Little et al. argue that these entities are corruptible by nature and that certain individuals are prone to take advantage of the corruptibility of social entities to pursue their own ends. The authors state that this is not preventable, so the way (...) to remedy corruption is via management and, where necessary, punishment. This commentary will briefly lay out the key features and functions of corruption as presented by Little et al., before providing a critical discussion that will focus on whether corruptibility is a necessary feature of social entities. I will propose that it is not a necessary feature, though it may frequently arise where individualistic values are unchecked. Corruption can be prevented within social entities by enhancing structures that direct toward virtue and which promote and reward cooperation instead of competition. (shrink)