Guillemin Marilys, Gillam Lynn
M. Guillemin is professor, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. L. Gillam is professor, Centre for Health Equity, School of Population and Global Health, University of Melbourne, and academic director, Children's Bioethics Centre, Royal Children's Hospital, Melbourne, Victoria, Australia.
Acad Med. 2015 Jun;90(6):726-31. doi: 10.1097/ACM.0000000000000709.
Clinical care is laden with emotions, from the perspectives of both clinicians and patients. It is important that emotions are addressed in health professions curricula to ensure that clinicians are humane healers as well as technical experts. Emotions have a valuable and generative role in health professional ethics education.The authors have previously described a narrative ethics pedagogy, the aim of which is to develop ethical mindfulness. Ethical mindfulness is a state of being that acknowledges everyday ethics and ethically important moments as significant in clinical care, with the aim of enabling ethical clinical practice. Using a sample narrative, the authors extend this concept to examine five features of ethical mindfulness as they relate to emotions: (1) being sensitized to emotions in everyday practice, (2) acknowledging and understanding the ways in which emotions are significant in practice, (3) being able to articulate the emotions at play during ethically important moments, (4) being reflexive and acknowledging both the generative aspects and the limitations of emotions, and (5) being courageous.The process of writing and engaging with narratives can lead to ethical mindfulness, including the capacity to understand and work with emotions. Strategies for productively incorporating emotions in narrative ethics teaching are described. This can be a challenging domain within medical education for both educators and health care students and thus needs to be addressed sensitively and responsibly. The potential benefit of educating health professionals in a way which addresses emotionality in an ethical framework makes the challenges worthwhile.
从临床医生和患者的角度来看,临床护理都充满了情感。在卫生专业课程中关注情感很重要,以确保临床医生既是技术专家,也是有人道精神的治疗者。情感在卫生专业伦理教育中具有宝贵且具有建设性的作用。作者之前描述了一种叙事伦理教学法,其目的是培养伦理正念。伦理正念是一种存在状态,它承认日常伦理和临床护理中具有伦理重要性的时刻,旨在实现符合伦理的临床实践。作者通过一个示例叙事,扩展了这一概念,以审视与情感相关的伦理正念的五个特征:(1)在日常实践中对情感敏感;(2)认识并理解情感在实践中的重要意义;(3)能够清晰表达在伦理重要时刻所涉及的情感;(4)进行反思,既承认情感的建设性方面,也承认其局限性;(5)勇敢无畏。撰写和参与叙事的过程可以带来伦理正念,包括理解和应对情感的能力。文中描述了在叙事伦理教学中有效融入情感的策略。对于教育工作者和医学生而言,这在医学教育中可能是一个具有挑战性的领域,因此需要谨慎且负责地加以应对。以在伦理框架内处理情感的方式培养卫生专业人员,其潜在益处使得这些挑战是值得的。