Daher Michel
J Med Liban. 2006 Jul-Sep;54(3):121-3.
The unprecedented progress in biomedical sciences and technology during the last few decades has resulted in great transformations in the concepts of health and disease, health systems and healthcare organization and practices. Those changes have been accompanied by the emergence of a broad range of ethical dilemmas that confront the health professionals more frequently in an increasing range of problems and situations. Health care that has been practiced for centuries on the basis of a direct doctor-patient relationship has been increasingly transformed to a more complex process integrating the health-team, the patient (healthcare seeker) and the community. Systematic review of the specialized literature revealed that Healthcare Ethics Education became a basic requirement for any training program 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. There is growing evidence that physicians' professional and moral development is not 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 educators.
在过去几十年中,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的概念、卫生系统以及医疗保健组织与实践发生了巨大变革。这些变化伴随着一系列广泛的伦理困境的出现,这些困境在越来越多的问题和情况下更频繁地摆在卫生专业人员面前。几个世纪以来一直基于直接医患关系开展的医疗保健,已日益转变为一个将医疗团队、患者(寻求医疗保健者)和社区整合在一起的更为复杂的过程。对专业文献的系统回顾表明,医疗保健伦理学教育已成为卫生专业人员任何培训项目的一项基本要求,并且应涵盖本科、研究生和继续教育的不同阶段。恰当的伦理推理、伦理态度和决策既需要理论基础,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并非由正式的伦理学课程决定,而更多地是由专业实践的道德环境,即“隐性课程”决定,这值得医学教育工作者认真思考。