Rodulson Victoria, Marshall Robert, Bleakley Alan
Peninsula Medical School, Universities of Exeter and Plymouth, Truro, Cornwall, UK.
University of Exeter Medical School, Truro, Cornwall, UK.
Med Humanit. 2015 Dec;41(2):95-101. doi: 10.1136/medhum-2015-010673. Epub 2015 May 6.
'Thinking with Homer', or drawing creatively on themes and scenes from Homer's Iliad and Odyssey, can help us to better understand medical culture and practice. One current, pressing, issue is the role of the whistleblower, who recognises and exposes perceived poor practice or ethical transgressions that compromise patient care and safety. Once, whistleblowers were ostracised where medical culture closed ranks. However, in a new era of public accountability, medicine looks to formally embrace whistleblowing to the point that not reporting transgressions can now constitute a transgression of professionalism. Where medical students identify with the history and traditions of medical culture, they inevitably find themselves in situations of conflicting loyalties if they encounter senior clinicians behaving unprofessionally. What are the implications of facing these dilemmas for students in terms of role modelling and shaping of character as a doctor, and how might a study of Homer help with such dilemmas? We suggest that a close reading of an opening scene in Homer's the Iliad can help us to better appreciate such ethical dilemmas. We link this with the early Greek tradition of parrhesia or 'truth telling', where frankly speaking out against perceived injustice is encouraged as resistance to power and inappropriate use of authority. We encourage medical educators to openly discuss perceived ethical dilemmas with medical students, and medicine as a culture to examine its conscience in a transition from an authoritarian to an 'open' society, where whistleblowing becomes as acceptable and necessary as good hygiene on the wards.
“与荷马一同思考”，或者创造性地借鉴荷马《伊利亚特》和《奥德赛》中的主题与场景，能够帮助我们更好地理解医学文化与实践。当前一个紧迫的问题是举报人所扮演的角色，举报人会识别并揭露那些被认为有损患者护理与安全的不良行为或道德违规行为。曾经，在医学文化内部团结一致时，举报人会遭到排斥。然而，在一个强调公共问责的新时代，医学似乎正正式接纳举报行为，以至于如今不举报违规行为可能会构成职业操守的违规。如果医学生认同医学文化的历史与传统，那么当他们遇到资深临床医生行为不专业时，不可避免地会发现自己面临忠诚冲突的局面。对于医学生而言，面对这些困境在榜样塑造和医生品格形成方面会有哪些影响？对荷马的研究又如何有助于解决这些困境呢？我们认为，仔细研读荷马《伊利亚特》中的一个开篇场景能够帮助我们更好地理解此类道德困境。我们将此与希腊早期直言不讳或“讲真话”的传统联系起来，在这种传统中，鼓励坦率地说出所察觉到的不公正，以此作为对权力和不当权威使用的一种抵抗。我们鼓励医学教育工作者与医学生公开讨论所察觉到的道德困境，并鼓励医学作为一种文化，在从专制社会向“开放”社会的转变过程中审视自身的良知，在这样的社会中，举报行为变得如同病房里良好的卫生习惯一样可接受且必要。
