Hattab Abdulla Saeed
Dev World Bioeth. 2004 Dec;4(2):160-72. doi: 10.1111/j.1471-8731.2004.00091.x.
The unprecedented progress in bio-medical sciences and technology during the last few decades has resulted in great transformations in the concepts of health and disease, health systems and healthcare organisation and practices. Those changes have been accompanied by the emergence of a broad range of ethical dilemmas that confront health professionals more frequently. The classical Hippocratic ethical principles, though still retaining their relevance and validity, have become insufficiently adequate in an increasing range of problems and situations. Healthcare that has been practised for centuries on the basis of a direct doctor-patient relationship has been increasingly transformed into a more complex process integrating the health-team, the patient (healthcare seeker) and the community. Systematic review of the specialised literatures revealed that Healthcare Ethics education has become a basic requirement for any training programme for health professionals, and should cover the different stages of undergraduate, postgraduate and continuing education. Both theoretical foundations and practical skills are required for the appropriate ethical reasoning, ethical attitude and decision-making abilities. There is growing evidence that physicians' professional and moral development is not only determined by the formal curriculum of ethics; rather more, it is determined by the moral environment of the professional practice, the 'hidden curriculum' which deserves serious consideration by medical education.
在过去几十年里,生物医学科学与技术取得了前所未有的进展,这导致了健康与疾病、卫生系统以及医疗保健组织和实践等概念的巨大转变。这些变化伴随着一系列广泛的伦理困境的出现,这些困境更频繁地困扰着卫生专业人员。经典的希波克拉底伦理原则虽然仍然具有相关性和有效性,但在越来越多的问题和情况下已变得不够充分。几个世纪以来一直基于直接医患关系进行的医疗保健,已日益转变为一个更复杂的过程,这个过程整合了医疗团队、患者(寻求医疗保健者)和社区。对专业文献的系统综述表明,医疗保健伦理学教育已成为卫生专业人员任何培训计划的基本要求,并且应涵盖本科、研究生和继续教育的不同阶段。适当的伦理推理、伦理态度和决策能力既需要理论基础也需要实践技能。越来越多的证据表明,医生的专业和道德发展不仅取决于伦理学的正式课程;更确切地说,它取决于专业实践的道德环境,即医学教育应认真考虑的“隐性课程”。