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探讨英国住院医师感知的医学伦理和法律培训需求。

Exploring the perceived medical ethics and law training needs of UK foundation doctors.

机构信息

Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.

University Hospitals of Morecambe Bay Foundation Trust, Lancaster, UK.

出版信息

Med Teach. 2020 Jan;42(1):92-100. doi: 10.1080/0142159X.2019.1665636. Epub 2019 Sep 26.

Abstract

Foundation doctors (FDs) encounter a wide range of ethical and legal issues during their first two years of work. Despite ethics being a key part of most modern undergraduate curricula, FDs can struggle with the issues they see. This study is based on results from an on-line survey answered by 479 UK FDs regarding their medical law and ethics learning needs, and their undergraduate training in this area. Over two-thirds stated they would wish to receive MEL training as an FD on self-discharge against medical advice (∼71%), sedating patients (∼70%), decision making in emergency medicine (∼67%), and withholding and withdrawing treatment (∼66%). Over half of all respondents want MEL training during their Foundation Programme on DNACPR orders (∼63%), dealing with patients with suicidal intent (∼59%), Mental Health Act (∼55%), Deprivation of Liberty Safeguards (∼54%), and end of life care (∼53%). We therefore propose a minimum curriculum for ethics and law training for FDs based on these topics, as well as cases brought by the FDs themselves.

摘要

住院医师(FDs)在工作的头两年会遇到各种各样的伦理和法律问题。尽管伦理是大多数现代本科课程的重要组成部分,但FDs可能会在他们看到的问题上感到困惑。这项研究基于一项在线调查的结果,该调查由 479 名英国 FDs 回答,内容涉及他们的医学法律和伦理学习需求,以及他们在这方面的本科培训。超过三分之二的人表示,他们希望在成为 FD 后接受 MEL 培训,内容涉及自行出院、违背医嘱(约 71%)、给患者镇静(约 70%)、急诊决策(约 67%)以及拒绝治疗或停止治疗(约 66%)。超过一半的受访者希望在基础课程中接受 MEL 培训,内容涉及 DNACPR 医嘱(约 63%)、处理有自杀倾向的患者(约 59%)、精神卫生法(约 55%)、自由限制保障措施(约 54%)以及临终关怀(约 53%)。因此,我们根据这些主题以及 FDs 自身提出的案例,为 FDs 的伦理和法律培训制定了一个最低课程。

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