Yavari Neda
PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Med Ethics Hist Med. 2016 Nov 23;9:16. eCollection 2016.
In the last few years, medical education policy makers have expressed concern about changes in the ethical attitude and behavior of medical trainees during the course of their education. They claim that newly graduated physicians (MDs) are entering residency years with inappropriate habits and attitudes earned during their education. This allegation has been supported by numerous research on the changes in the attitude and morality of medical trainees. The aim of this paper was to investigate ethical erosion among medical trainees as a serious universal problem, and to urge the authorities to take urgent preventive and corrective action. A comparison with the course of moral development in ordinary people from Kohlberg's and Gilligan's points of view reveals that the growth of ethical attitudes and behaviors in medical students is stunted or even degraded in many medical schools. In the end, the article examines the feasibility of teaching ethics in medical schools and the best approach for this purpose. It concludes that there is considerable controversy among ethicists on whether teaching ethical virtues is plausible at all. Virtue-based ethics, principle-based ethics and ethics of care are approaches that have been considered as most applicable in this regard.
在过去几年里，医学教育政策制定者对医学实习生在教育过程中的道德态度和行为变化表示担忧。他们声称，新毕业的医生（医学博士）进入住院医师培训阶段时，带着在教育过程中养成的不当习惯和态度。这一指控得到了众多关于医学实习生态度和道德变化的研究支持。本文的目的是将医学实习生中的道德沦丧作为一个严重的普遍问题进行调查，并敦促当局采取紧急的预防和纠正措施。从科尔伯格和吉利根的观点对普通人道德发展过程进行比较后发现，在许多医学院校，医学生道德态度和行为的成长受到阻碍，甚至出现退化。最后，本文探讨了医学院校开展伦理教学的可行性以及为此目的的最佳方法。结论是，伦理学家们对于教授伦理美德是否可行存在相当大的争议。基于美德的伦理学、基于原则的伦理学和关怀伦理学是在这方面被认为最适用的方法。
