Liaschenko J, Oguz N Y, Brunnquell D
Center for Bioethics, University of Minnesota, N504 Boynton Hall, 410 Church Street SE, Minneapolis, MN 55455, USA.
J Med Ethics. 2006 Nov;32(11):672-7. doi: 10.1136/jme.2005.013060.
It is time for the noon conference. Your job is to impart a career-changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1 1/2 h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this "tragic case" approach to ethics education is of limited value because it limits understanding of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider-patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties.
中午会议时间到了。你的任务是向一群来自四所不同学校、伦理学课程各异的学生和实习生传授一次改变职业的伦理学体验。他们刚刚结束了1个半小时的理论课程和午餐。其中三分之一的人昨晚还在值班。你的首要任务是让他们保持清醒。作者认为,这种以“悲剧案例”进行伦理学教育的方法价值有限,因为它将对道德问题的理解局限于困境;否定了学生的道德能动性;鼓励的只是理论上的解决方案;并暗示伦理遭遇是专家的事情。作者提出了一种替代方法,该方法关注三个问题:医患关系、日常医疗工作中医疗人员之间的关系以及医疗人员在社会中的社会地位。在这种方法中,教师不是专家,而更像是旅程中的向导,帮助学生认识到许多伦理实践包括经历照顾弱势群体的艰难处境,并帮助学生应对其中的一些困难。