Primum non tacere An Ethics of Speaking up

There are many reasons why [medical] students find it difficult to up. Some do not think it is their place or job to do so. Some are about possible adverse effects on their grades, particularly when clerkships in specialties they hope to enter. Some fear that they will subjected to ridicule for asking a question or expressing a concern. Some that it is considered improper to criticize fellow physicians. Some want be viewed as loyal to the team, and few want to be seen as a rat or. In spite of the reasons that make it difficult for students to up, I have argued that they have an obligation to do so. But by focusing students' obligations I did not mean to excuse the people above them. up is a problem for everyone in medicine, and those with more power authority have a greater obligation to confront the problem. They have a to speak up and a responsibility to try to change the that make it so difficult for those below them to speak up....I I am really suggesting that the practice of medicine needs to become Socratic. Perhaps medicine could not function if everyone acted like -- perhaps there would be too much discussion and too little patient. Yet I believe that medicine could function quite well if everyone were a more Socratic, a little more willing to raise questions about what is and good.