Scribd
Upload
665 views2 pages

Merci Note

MERCI is a systematic approach and "aide memoir" for clinicians to consider key ethical issues in a busy clinical setting. It stands for: M - Ensuring all medical problems are properly dealt with E - Being aware of and expressing empathy for the patient's emotions R - Respecting the patient's rights such as knowledge, treatment options, autonomy, and confidentiality C - Ensuring effective communication I - Reflecting on the patient's understanding of their illness and the team's understanding of their social and cultural context Using MERCI during ward rounds can increase awareness of medical ethics issues without taking up significant curriculum time. Further evaluation of its effectiveness is planned.

Uploaded by

Subbash Ekambaram
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
665 views2 pages

Merci Note

MERCI is a systematic approach and "aide memoir" for clinicians to consider key ethical issues in a busy clinical setting. It stands for: M - Ensuring all medical problems are properly dealt with E - Being aware of and expressing empathy for the patient's emotions R - Respecting the patient's rights such as knowledge, treatment options, autonomy, and confidentiality C - Ensuring effective communication I - Reflecting on the patient's understanding of their illness and the team's understanding of their social and cultural context Using MERCI during ward rounds can increase awareness of medical ethics issues without taking up significant curriculum time. Further evaluation of its effectiveness is planned.

Uploaded by

Subbash Ekambaram
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

MERCI

A Useful Systematic Aide Memoir for Clinicians in


Teaching Ethics
Professor Zabidi Azhar Hussin
Introduction
Medical educationists worldwide have long recognized the importance of ethics in the
training of medical doctors. Various approaches and guidelines have been proposed and
formalized either globally or regionally in Canada, Europe, and Australasia. The true
effectiveness of these approaches has not been exhaustively evaluated. The long list of
ethical subjects considered core knowledge are often prohibitive for clinicians to be
taught in a busy clinical setting. Their particular apprehension is that added curriculum
space for teaching ethics will compromise the clinical content of medical specialties.
(Reference needed). Outsourcing the teaching of ethics to non clinical experts, on the
other hand, risks making clinicians more distant to the subject. A systematic thinking
approach that can serve as an aide memoir to clinicians in their daily routine clinical
service on the subject of ethics is thus very much needed.
MERCI acronym gives a quick guide on core contents of ethics and can be a useful
tool to be used during ward rounds.

M (MEDICAL) ensures that all acute and non acute medical problems relevant to the
patient have been properly dealt with.
E, (EMPATHY), includes an awareness of the patients emotions and ability to express
that awareness to the patient.
R, (RIGHTS) is a reminder whether sufficient respect for patients rights has been
shown. These include rights for knowledge, treatment options, autonomy of decisionmaking, and confidentiality.
C, (COMMUNICATON) ensures that all matters pertaining to effective
communications have been satisfactorily dealt with.
I, (INSIGHT) give a quick reflection to the physician whether the patient has a full
insight of his illness and whether the attending team has appreciated the complete
understanding of each patient including, social and cultural considerations.
Having such a thinking frame would enable clinicians to quickly consider the various
ethical issues with his students and medical officers before moving on to see another
patient in a busy ward round. We found from our brief experience that this approach
helps to increase awareness of medical ethics in a busy clinical setting. Further evaluation
of its effectiveness is currently planned.

Take home message


M: Medical problem properly dealt with
E: Empathy to patients emotions
R: Respect for patients rights
C: Effective communication
I: Patients insight to his illness & attending team understand patients social &
cultural background

References:
1. Selvakumar D, Joseph LBM. 2004. The importance of including bio-medical
ethics in the curriculum of health education institutes. Educ Health (Abingdon)
17:93-6.
2. Doyal L, Gillon R. 1998. Medical ethics and law as a core subject in medical
education. BMJ 316:1623-4.
3. Medical ethics manual, 2009 2nd edition. World Medical Association Ethics Unit
4. Family medicine bioethics curriculum; clinical cases and reference. 2005. Ethics
committee of the college of family physician of Canada.
5. Teaching of medical ethics in basic and continuing medical education. 1992.
Comite Permanent Des Medecins Europeens (Standing Committee of European
Doctors). CP 1992 162
6. Medical Ethics Core Curriculum on Consent, Confidentiality and Human Rights.
Comite Permanent Des Medecins Europeens (Standing Committee of European
Doctors). 2008. CPME 2008/159 final EN/Fr.
7. Braunack-Mayer AJ, Gillam LH, Vance EF et al. 2001. An ethics core curriculum
for Australasian medical schools. Med J Aust 175:205-10.
8. Stepien KA, Baernstein A. 2006. Educating for empathy; A review. J Gen Intern
Med 21:524-30.

You might also like