Ineichen Christian, Christen Markus, Tanner Carmen
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006, Zurich, Switzerland.
University Research Priority Program Ethics, Zollikerstrasse 117, 8008, Zurich, Switzerland.
BMC Med Ethics. 2017 Jan 28;18(1):5. doi: 10.1186/s12910-016-0164-7.
Value sensitivity - the ability to recognize value-related issues when they arise in practice - is an indispensable competence for medical practitioners to enter decision-making processes related to ethical questions. However, the psychological competence of value sensitivity is seldom an explicit subject in the training of medical professionals. In this contribution, we outline the traditional concept of moral sensitivity in medicine and its revised form conceptualized as value sensitivity and we propose an instrument that measures value sensitivity.
We developed an instrument for assessing the sensitivity for three value groups (moral-related values, values related to the principles of biomedical ethics, strategy-related values) in a four step procedure: 1) value identification (n = 317); 2) value representation (n = 317); 3) vignette construction and quality evaluation (n = 37); and 4) instrument validation by comparing nursing professionals with hospital managers (n = 48).
We find that nursing professionals recognize and ascribe importance to principle-related issues more than professionals from hospital management. The latter are more likely to recognize and ascribe importance to strategy-related issues.
These hypothesis-driven results demonstrate the discriminatory power of our newly developed instrument, which makes it useful not only for health care professionals in practice but for students and people working in the clinical context as well.
价值敏感性——即在实践中出现与价值相关的问题时能够识别这些问题的能力——是医学从业者参与与伦理问题相关的决策过程中不可或缺的一项能力。然而，价值敏感性这一心理能力在医学专业人员的培训中很少成为明确的主题。在本论文中，我们概述了医学中道德敏感性的传统概念及其被概念化为价值敏感性的修订形式，并提出了一种测量价值敏感性的工具。
我们通过四个步骤开发了一种用于评估对三类价值（与道德相关的价值、与生物医学伦理原则相关的价值、与策略相关的价值）的敏感性的工具：1）价值识别（n = 317）；2）价值呈现（n = 317）；3）情景构建与质量评估（n = 37）；4）通过比较护理专业人员和医院管理人员来进行工具验证（n = 48）。
我们发现，与医院管理人员相比，护理专业人员更能识别并重视与原则相关的问题。而医院管理人员更有可能识别并重视与策略相关的问题。
这些由假设驱动的结果证明了我们新开发的工具的区分能力，这使得它不仅对实际工作中的医疗保健专业人员有用，对学生以及临床环境中的工作人员也有用。
