医学生之医学伦理素养教育剖辨

对医学生加强医学伦理素养教育是当前国内外医学教育的共识,但在教育的内容、方式和方法上却是各具特色.相对而言,我国医学院校对医学生的医学伦理素养教育尚处于不成熟的阶段,其表现就是教育过程中存在着诸多的问题、教学效果不甚理想.从医学伦理素养教育的现状入手,尝试分析我国医学伦理素养教育中的重点和难点问题.     

中国古代医德教育对现代医学生医德教育的启示

医德医风已成为全社会普遍关注的焦点,特殊职业要求医务工作者应具有高尚的医德,而高尚医德的培养应从医学生教育阶段开始,努力提高医学生的医德素养。我国传统的医德教育方法,如医学生人品的选拔,老师言传身教,徒弟满师传统等等对于培养现代医学生关爱病人、救死扶伤的医德风范仍具有积极的借鉴意义。     

医学伦理学是否可教及其他--关于医学伦理学教育的再思考

医学伦理学是否可教?如果可教,应该教规范还是教价值?如何拉近医学伦理学教育与现实的距离?怎样评价医学伦理学教学的效果?不仅是临床医生和卫生管理工作者,即使作为医学伦理学研究工作的学者也都对这些问题存在着不同程度的误解,这影响了医学伦理学学科地位的确立.     

Medical Ethics,Bioethics and Research Ethics Education Perspectives in South East Europe in Graduate Medical Education

Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia (47.5 h per year), and the lowest was in Serbia (14.8). In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours.     

Reflections on teaching health care ethics on the web

As web instruction becomes more and more prevalent at universities across the country, instructors of ethics are being encouraged to develop online courses to meet the needs of a diverse array of students. Web instruction is often viewed as a cost-saving technique, where large numbers of students can be reached by distance education in an effort to conserve classroom and instructor resources. In practice. however, the reverse is often true: online courses require more of faculty time and effort than do many traditional classes. Based on personal experience teaching an online course in health care ethics for students in the Allied Health Professions, it is evident that there are both benefits and challenges in teaching online courses, particularly in ethics. Examples of benefits are (1) the asynchronous nature of web instruction allows students to progress through the course at their own pace and at times that are convenient given their clinical responsibilities; (2) web courses allow for a standardization of content and quality of instruction over a diversity of programs; and (3) examples can be tailored to the differing experiences of students in the course. Some challenges to teaching online ethics courses include (1) the fact that online instruction benefits visual learners and disadvantages those lacking good reading comprehension or strong writing skills; (2) developing meaningful student-student and student-instructor interaction; and (3) teaching ethics involves teaching a process rather than a product. Allowing students to apply their knowledge to real-world cases in their disciplines and encouraging them to share experiences from clinical practice is an effective way to meet several of these challenges. Building an online community is another good way to increase the interaction of students and their engagement with the material.     

Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

案例教学的医学伦理学再造

我国医学伦理学采用案例教学法已经有二十余年的历史了。在此期间,案例教学得到了一定的发展,却也受到了诸多因素的限制。当前,中国医学伦理学的案例教学朝哪里去、怎么去等一系列新的问题摆在我们面前,这些问题必须依赖于加强我国医学伦理学软件环境的建设并对案例教学进行医学伦理学的再造方能加以解决。     

当前高校“思想道德修养”课教学内容存在问题探析

“思想道德修养”课教学效果不佳,缺乏感召力和说服力,其重要原因之一就是教学内容存在问题。教育所组织、编制和传授的教学内容没能处理好先进性与一般性的关系;没能处理好政治性与品德性的关系;没能处理好抽象性与具体性的关系;没能处理好继承性与创新性的关系;没能处理好知识性与行为性的关系。对教学内容存在问题的探讨,是我们深化教学内容研究和改革的前提和基础,是实现“思想道德修养”课教学有效性的根本保证。     

From innocence to experience: Teaching medical ethics to medical students

The author describes the content and method of a course in medical ethics for second-year medical students. He discusses the clergyperson's role in teaching medical ethics in relationship to physicians and concludes with reflections upon the study of medical ethics as part of the rite of passage of medical education.     

医科生医德认知度影响因素分析

通过对医务人员和在校医科生的广泛问卷调研,我们发现,医科生还普遍存在着医学伦理学基础知识不牢、过于重视医学专业知识的学习而轻视人文哲学社会科学知识的学习,以及轻视高尚人生观的追求等诸多问题。为此,我们可以采取多种综合性的措施来强化医德教育的有效性,全面提升医学生的医德认知度水平。关键词:医德认知度;医德修养;创新;     

Evoking the moral imagination: Using stories to teach ethics and professionalism to nursing,medical, and law students

Four years ago, as colleagues in our university's law and medical schools, we designed and began offering a course for law, medical, and nursing students, studying professionalism and professional ethics by reading and discussing current and earlier images of nurses, doctors, and lawyers in literature. We wanted to make professional ethics, professional culture, and professional education the objects of study rather than simply the unreflective consequences of exposure to professional language, culture, and training. We wanted to do it in an interdisciplinary course where aspiring professionals could share their self-conceptions and their conceptions of each other, and we wanted to do it by using stories, our primary means for organizing experience and claiming meaning for it. This article tells the story of that experience: why we did it; how we did it; what we learned from doing it.     

An Approach to Teaching Ethics Courses in Human Services and Counseling

This article presents multiple facets of a team approach to teaching and facilitating an ethics course for undergraduate human services students and a graduate ethics course for students majoring in counseling. Starting with general points, this article describes a specific, week‐to‐week approach to a 1‐semester course, concluding with sample student evaluative comments and an experienced professor/author's processing of the experience of preparing and teaching this course for many years.     

Teaching Bioethics to a Large Number of Biology and Pharma Students: Lessons Learned

To be made aware of bioethical issues related to their disciplines, undergraduate students in biology and pharmaceutical sciences at the University of Basel are required to enroll in the bioethics course called “Introduction to Bioethics”. This article describes the chances and challenges faced when teaching a large number of undergraduate biology and pharmaceutical sciences students. Attention is drawn to the relevance and specific ethical issues that biology and pharmaceutical sciences students may be confronted with and to how these could be integrated into ethics curricula. Results from a survey addressing the knowledge and opinion of students taking the course in spring semester 2012, 2013, and 2014 are presented and discussed. Finally, we describe the lessons learned and how we have improved the course based on students’ feedback throughout the following years.     

I Believe I Am So Called: Reflections on a Vocation in Medical Education

This essay is concerned with the fulfillment of ordination commitments through a pastoral role in medical education and review of medical research with human subjects. Stylistically, it combines memoir with the genre known as “creative non-fiction.” Its major issues have to do with the identity formation and transformation of the author, the function and ethics of institutional review boards, the teaching of medical ethics to medical students, and courses involved in the doctor–patient relationship and in palliative care intended to increase the sensitivity and self-awareness of physicians-in-becoming. This essay was presented in its initial form at the Annual Fellows Meeting of the Society for Values in Higher Education in 2010.     

The Use of Narrative in Jewish Medical Ethics

Anne Jones has pointed out that over the last three decades, stories have been important to medical ethics in at least three ways: (1). Stories as cases for teaching principle-based medical ethics (2). Narratives for moral guides on what is considered living a good life (3). Stories as testimonials written by both patients and physicians. A pioneer in this effort, particularly in regard to using narratives as moral guides, has been the ethicist and philosopher Stanley Hauerwas. Heavily influenced by virtue ethics, Hauerwas believes that it is a person’s particular narrative tradition that provides one with convictions that form the basis of one’s morality. Befitting a Protestant theologian, he is particularly concerned with the Christian narrative. From a Jewish perspective, there has been much less written on the use of narrative in medical ethics. However, it is a mistake to think that narrative has little, if any, role in Rabbinic ethical decision making. The purpose of this article is to demonstrate the centrality of narrative in the thought of Orthodox Jewish decisors and the problems inherent in this methodology.     

医生医疗行为失范的成因与对策

秦瑞霞张学义王丽娜社会转型带来的医德人格扭曲、医疗行政监管缺位和医疗行为中的诸多法律盲区等是医生医疗行为失范的主因。强化新伦理观教育实现医德建设的与时俱进、创新医疗行政管理制度、出台进一步规范医疗行为的法律法规是矫治医生医疗行为失范的对策。     

案例教学与医学伦理学教育

案例教学已经成为普遍的方法在我国各医学院校的医学伦理学教学中广泛使用,案例教学作为一种方法,如何客观地看待它,需结合医学伦理学教育的目的和内容。案例教学具有增加互动、加深理解和提高分析能力等优点,但如果驾驭不好,也会暴露一些弱点,而起到反作用。试图还案例教学法于医学伦理学教育的本来位置。     

当代中国医德建设与相对主义医学伦理学

当代西方相对主义医学伦理学有许多建树,但也有其致命性的缺陷,这就是否定医学道德的客观绝对性和普遍性医学伦理准则。在引进、介绍了这种学说之后,需要下功夫同它进行对话,即以医德绝对性与相对性辩证统一的原理,对这种学说进行追问,从中借鉴有益的经验和教训,以顺利全面地推进我国当代的医学道德建设。     

Some reflections on postgraduate medical ethics education

Three goals of teaching medical ethics to physicians are reviewed. Components of a basic course in medical ethics are described with special attention to the roles of case conferences, ethics rounds, and role modeling. Obstacles to teaching ethics are also addressed.     

国外军事医学伦理学的发展概论

走入战场的医生与正在进行与军事有关的医学研究的人员应具有的独特伦理准则,是军事医学伦理学研究的核心。但是军事医学伦理的准则始终受到战争的挑战。在新的反恐战争中,西方的军事医学伦理困惑聚增,使这一学科迅速发展并经历激烈争论。我们应关注西方的医学伦理在军事领域的延伸。