There is no objection that the medical ethics enters basic matters of the undergraduate medical education. The curriculum plan of medical ethics in the medical school in our country is proposed. This curriculum aims at the participating education that the student personally chooses and discovers the result to be studied instead of the passive lecture like the boring preaching from the platform. This is the curriculum throughout a few years, because it is necessary to repeatedly study adjusting to the learning achievement.

We proposed the curriculum plan of medical ethics in the medical school in our country. That was the curriculum throughout a few years and the participating education. Now we present the manual for one case of the each six strategies. When the teacher holds classes according to this manual or with some modifications, the medical students will probably participate the education with high motivation to learn.

The first workshop on medical ethics education was held for 28 members including mainly university tutors and hospital tutors in November 2002 at Gifu. Trail for training of several kinds of medical ethics education technique was evaluated to a certain extent. We submit report of the practice and participants' evaluation of the workshop.

From 1986 to 1991, 49 malignancies were found in sonographic examination of 53, 788 subjects carried out by the Kumamoto Prefectual Welfare Federation of Agricultural Cooperatives. The cases were composed of 12 hepatocellular carcinomas, 11 metastatic liver tumors, 11 renal cell carcinomas, 6 gall bladder carcinomas, 3 gastric carcinomas and 6 ether malignancies including metastatic pancreas tumors and ovarian tumors. A follow-up survey was made in 37 cases. All the case of renal cell carcinoma were found in an early stage and showed the best prognosis; the 2-year survival rate was 100%(n=7). In hepatocellular carcinomas 1-year and 2-year survival rates were 85% and 33%, respectively. Eight of 11 metastatic liver tumors were f rom gastrointestinal malignancies, and prognosis was poor; 1-and 2-year survival rates were 44% and 37%, respectively. Gastric carcinomas were found with lymphadenopathy or the thickening of the gastric wall, so prognosis was quite poor. Abdominal sonography has proved to be a very convenient and safe procedure to find out malignancies in the early stage. In detected (asymptomatic) cases of renal cell carcinoma, prognosis was excellent.

To examine the present state of postgraduate ethics education for residents in Japan, we sent an anonymous self-administered questionnaire to the directors of all 640 hospitals in Japan with a registered postgraduate clinical residency program. A total of 258 hospitals returned the questionnaire (response rate: 40.3%). Of these hospitals, 69 (26.7%) had a program for ethics education and 189 (73.3%) did not. The presence of a program was strongly correlated with the number of hospital beds and a history of problems with ethics education. Respondents showed a high degree of awareness about such significant topics in ethics education as “informed consent, ” “patient privacy, ” “patient rights, ” and “physician duties.”