1. Utilizing Continuing Medical Education to Advance Bioethics in Taiwan Opportunities and Challenges Hsiui-I Yang, Mu-Li Wu 2004/02/15

2. Themes of the Paper Past: Ethic-vacuum society Current: Opportunities with the License Renewal Requirement Future: Challenges ahead

3. Background Physician Act (2002) Regulations Governing the Licensing and Continuing Education of Physicians (2003)

4. Article 8, Physician Act Amended, January 16, 2002 1.… 2.Practicing physicians shall receive continuing education and submit documentary proof of completed continued education every six years to renew their practice license.

5. Regulations Governing the Licensing and Continuing Education of Physicians, April 23, 2003 Article 9 A practicing physician shall receive a minimum of 180 credits of continuing education on the following subjects: 1. professional knowledge; 2. professional ethics; 3. laws and regulations relevant to the profession; 4. medical quality Cumulative credits for Items 2 to 4 above shall be a minimum of 18 credit points.

6. Opportunities Ideally, Continuing Medical Education can bridge the gap between school education and daily practice. With appropriate ethical training, individual physicians can keep competent in critical decision-making and stay compassionate in treating patients. Hopefully, Taiwan can be changed from an ethics-vacuum to an ethics-sensitive society.

7. Challenges Without a carefully designed system, CME of bioethics can easily become a legal formality to comply with, not only wasting attending physicians time and energy, exhausting their passion, but also alienate their devotions in treating patients.

8. Purposes of the paper Clarify the meaning of bioethics Exploring the relationship of Bioethics and Continuing Medical Education (CME) Critically Reviewing Continuing Medical Education System in Taiwan Identifying Implementing Factors Critical to Future Success

9. The Meaning of Bioethics What Bioethics isWhat Bioethics is Not Applied PhilosophyNormative Philosophy Finding questionsFinding answers Consensus buildingAuthority building For everybody to freely express his\her opinions For the senior to command the junior; the majority to manipulate the minority

10. The Importance of receiving CME of bioethics It becomes more and more easy for doctors nowadays to encounter bioethics dilemma in daily practices. School education on bioethics is barely sufficient

11. Ethical Dilemma frequently faced by Taiwanese Physicians Patients family beg you to conceal the diagnosis of cancer from the patient himself. Patients purchased human organ overseas Conflicting opinions between patients and family members in futile treatment

12. CME and Bioethics While bioethics is still evolving, CME provides the best platform to timely equip medical practitioners with necessary knowledge and decision- making skills

13. CME Systems in Taiwan SystemsProfession-directedStates-directed Period1986~20022002~ naturevoluntarymandatory ObjectsspecialistsAll physicians Main Law & Regulation s Diplomate Specialization and Examination Regulations – Chapter 5 Article 12 The Physicians Act – Chapter 2 Article 8 FeaturesEmphasize the role of professional discipline. Strengthen the governments interventions

14. Opportunities of the latest changes in CME System in Taiwan All physicians have to receive CME every six years Ethics is required subjects Increased Exposure and Awareness of Bioethics

15. Factors critical to future success What issues should be included? What methods should be selected to teach? How to measure the effectiveness of bioethics teaching program?

16. Challenges ahead Scope of teaching: Ex: truth telling, informed consent, substitute decision-making, conflict of interest, end-of- life issues Approaches of teaching: Ex: Case-base conference Evaluation of Performance

17. Conclusion Bioethical training is critical for practice of medicine nowadays. CME is the best platform to teach bioethics. Carefully-designed CME benefits not only the attending physicians. In return, via CME, we could find cultural distinctiveness of Taiwan bioethics, and as a result develop our own culturally sensitive bioethics.