How can we know that ethics education produces ethical doctors?

This article examines the challenges that medical ethics education faces, given its aim of producing ethical doctors. Starting with an account of the ethical doctor, it then inquires into the key areas of medical students’ ethical development, viz. knowledge, habituation and action, and describes more specific outcomes in these areas. Methods of teaching aimed at achieving specific outcomes are also discussed. The authors then turn to some difficulties that stand in the way of achieving the desired outcomes of medical ethics education, and survey what has been achieved so far, by considering a number of studies that have evaluated the efficacy of a range of medical ethics courses. The article concludes by suggesting that medical ethics education should give attention to the problems of evaluation of ethics curricula as the discipline comes of age.Practice points The aim of medical education is to develop doctors who are reflective, empathetic, trustworthy, committed to patient welfare and able to deal with complexity and uncertainty.Medical ethics should be multidisciplinary and multi-professional, academically rigorous, grounded in research, and fully integrated into the medical curriculum.Attention to evaluating ethics education is increasing, but there is a paucity of evidence regarding the effectiveness of medical ethics courses, and there are numerous problems in assessment design.The challenge of training ethical doctors lies in a rigorous evaluation of medical ethics teaching based on clearly defined outcomes and valid assessment methods.