Mitchell K R, Lovat T J, Myser C M
Faculty of Medicine, University of Newcastle, New South Wales.
Med Educ. 1992 Jul;26(4):290-300. doi: 10.1111/j.1365-2923.1992.tb00172.x.
Over the past two decades in the USA, bioethics has become an accepted component of medical education, whereas in Australia, 10 years or even less would encompass the history of most existing programmes. Given the legendary conservatism of medical schools in Australia and the intractability of the medical curriculum, this is still a remarkable achievement. But does the teaching of bioethics change the thinking and/or decision-making behaviour of medical students or practitioners exposed to such courses? Those involved know only too well how difficult such courses are to design and evaluate since the connection between ethics education and practice is not known and may never be demonstrated to the satisfaction of critics. Critics not only seek answers to the questions of whether the teaching of bioethics makes a difference, which is a fair question, but they also seek answers to the question of whether bioethics should be taught in medical schools. Can bioethics be taught? Whose bioethics is being taught? What does the trained bioethicist contribute? Some of these questions arise from misunderstanding and some reflect the still too dominant view in medical schools which divides disciplines into those which provide 'practical skills', and those which contribute only theoretical and therefore peripheral knowledge. The authors will address these questions in the light of their experience at Newcastle, Australia, where the Faculty of Medicine has been teaching bioethics for over a decade.
在美国,过去二十年来生物伦理学已成为医学教育中被认可的一部分,而在澳大利亚,大多数现有课程的历史不过十年甚至更短。鉴于澳大利亚医学院校久负盛名的保守主义以及医学课程的顽固性,这仍然是一项了不起的成就。但是,生物伦理学教学是否会改变接触此类课程的医学生或从业者的思维和/或决策行为呢?相关人士深知设计和评估此类课程有多困难,因为伦理教育与实践之间的联系尚不清楚,而且可能永远无法令批评者满意地得到证明。批评者不仅寻求关于生物伦理学教学是否有作用这一问题的答案(这是个合理的问题),还寻求关于生物伦理学是否应在医学院校教授这一问题的答案。生物伦理学能被教授吗?教授的是谁的生物伦理学?训练有素的生物伦理学家能做出什么贡献?其中一些问题源于误解,还有一些反映了医学院校中仍然占主导地位的观点,即将学科分为提供“实践技能”的学科和仅提供理论因而属于边缘知识的学科。作者将根据他们在澳大利亚纽卡斯尔的经验来探讨这些问题,在那里医学院已经教授生物伦理学十多年了。