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住院医师培训期间的医学伦理学教学。

Teaching medical ethics during residency.

作者信息

Perkins H S

机构信息

Department of Medicine, University of Texas Health Science Center, San Antonio.

出版信息

Acad Med. 1989 May;64(5):262-6. doi: 10.1097/00001888-198905000-00013.

Abstract

Because practicing physicians are poorly prepared to resolve many ethical issues that arise in patient care, this article proposes that residencies include practical training in medical ethics. Training in medical ethics helps physicians recognize ethical issues in patient care and resolve those issues wisely. Furthermore, such training has its maximum impact during the professionally formative years of residency. The article specifies key ethical concepts residents should know, including knowing how to obtain informed consent, knowing what to do about incompetent patients, knowing when to withhold or disclose clinical information, and knowing how to use resources properly. The article also points out that the success of residency training in ethics depends on strong commitments from the department: endorsement by the chairman and the residency program director; recruitment of several dedicated faculty; support for adequate ethics training for these faculty; dedication of conferences, rounds, and consultations to teaching ethics; and allocation of sufficient funds.

摘要

由于执业医师在解决患者护理中出现的许多伦理问题方面准备不足,本文建议住院医师培训应包括医学伦理学的实践培训。医学伦理学培训有助于医师识别患者护理中的伦理问题并明智地解决这些问题。此外,此类培训在住院医师职业形成期能产生最大影响。本文明确了住院医师应知晓的关键伦理概念,包括如何获得知情同意、如何处理无行为能力的患者、何时隐瞒或披露临床信息以及如何合理使用资源。本文还指出,住院医师伦理学培训的成功取决于科室的坚定承诺:系主任和住院医师培训项目主任的认可;招募几位敬业的教员;为这些教员提供足够的伦理学培训支持;将会议、查房和会诊专门用于伦理学教学;以及分配足够的资金。

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