Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, 1 Ben-Gurion Boulevard, Israel, P.O.B. 653, Beer-Sheva, Israel.
Soroka University Medical Center, Yitzhack I. Rager Blvd 151, 84101, Beer-Sheva, Israel.
J Bioeth Inq. 2019 Jun;16(2):217-225. doi: 10.1007/s11673-019-09897-2. Epub 2019 Mar 8.
To determine motives and attitudes towards life-sustaining treatments (LSTs) by clinical and preclinical medical students.
This was a scenario-based questionnaire that presented patients with a limited life expectancy. The survey was distributed among 455 medical students in preclinical and clinical years. Students were asked to rate their willingness to perform LSTs and rank the motives for doing so. The effect of medical education was then investigated after adjustment for age, gender, religion, religiosity, country of origin, and marital status.
Preclinical students had a significantly higher willingness to perform LSTs in all cases. This was observed in all treatments offered in cases of a metastatic oncologic patient and an otherwise healthy man after a traumatic brain injury (TBI). In the case of an elderly woman on long-term care, preclinical students had higher willingness to supply vasopressors but not perform an intubation, feed with a nasogastric tube, or treat with a continuous positive air-pressure ventilator. Both preclinical and clinical students had high willingness to perform resuscitation on a twelve-year-old boy with a TBI. Differences in motivation factors were also seen.
Preclinical students had a greater willingness to treat compared to clinical students in all cases and with most medical treatments offered. This is attributed mainly to changes along the medical curriculum. Changes in reasons for supplying LSTs were also documented.
确定临床和医学预科学生对维持生命治疗（LSTs）的动机和态度。
这是一项基于情景的问卷调查，向患者呈现有限的预期寿命。该调查在 455 名医学预科和临床学生中进行。要求学生评估他们进行 LST 的意愿，并对这样做的动机进行排名。然后，在调整年龄、性别、宗教、宗教信仰、原籍国和婚姻状况后，研究医学教育的效果。
在所有情况下，医学预科学生表现出更高的进行 LST 的意愿。这在转移性肿瘤患者和创伤性脑损伤（TBI）后健康男性的所有治疗中都有观察到。在长期护理的老年女性中，医学预科学生更愿意使用血管加压素，但不愿意进行插管、经鼻胃管喂养或使用持续正压通气治疗。医学预科和临床学生都非常愿意对 TBI 的十二岁男孩进行复苏。在动机因素方面也存在差异。
与临床学生相比，医学预科学生在所有情况下和提供的大多数医疗治疗中都更愿意进行治疗。这主要归因于医学课程的变化。还记录了提供 LST 的原因的变化。
