Department of Obstetrics and Gynecology, ABC Medical Center, Mexico City, Mexico.
Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA.
J Perinat Med. 2020 Sep 25;48(7):728-732. doi: 10.1515/jpm-2020-0123.
Objectives Violence against medical trainees confronts medical educators and academic leaders in perinatal medicine with urgent ethical challenges. Despite their evident importance, these ethical challenges have not received sufficient attention. The purpose of this paper is to provide an ethical framework to respond to these ethical challenges. Methods We used an existing critical appraisal tool to conduct a scholarly review, to identify publications on the ethical challenges of violence against trainees. We conducted web searches to identify reports of violence against trainees in Mexico. Drawing on professional ethics in perinatal medicine, we describe an ethical framework that is unique in the literature on violence against trainees in its appeal to the professional virtue of self-sacrifice and its justified limits. Results Our search identified no previous publications that address the ethical challenges of violence against trainees. We identified reports of violence and their limitations. The ethical framework is based on the professional virtue of self-sacrifice in professional ethics in perinatal medicine. This virtue creates the ethical obligation of trainees to accept reasonable risks of life and health but not unreasonable risks. Society has the ethical obligation to protect trainees from these unreasonable risks. Medical educators should protect personal safety. Academic leaders should develop and implement policies to provide such protection. Institutions of government should provide effective law enforcement and fair trials of those accused of violence against trainees. International societies should promulgate ethics statements that can be applied to violence against trainees. By protecting trainees, medical educators and academic leaders in perinatology will also protect pregnant, fetal, and neonatal patients. Conclusions This paper is the first to provide an ethical framework, based on the professional virtue of self-sacrifice and its justified limits, to guide medical educators and academic leaders in perinatal medicine who confront ethical challenges of violence against their trainees.
针对围产期医学领域医疗培训生遭受暴力这一现象，该研究旨在为医疗教育工作者和学术领导者提供一个伦理框架，以应对其中所涉及的紧迫的伦理挑战。尽管这些伦理挑战十分重要，但至今仍未得到足够的重视。
我们使用现有的批判性评估工具，对有关暴力侵害培训生的伦理挑战的文献进行了学术综述，以确定出版物。我们还进行了网络搜索，以确定墨西哥发生的针对培训生的暴力事件报告。借鉴围产期医学中的专业伦理，我们描述了一个独特的伦理框架，该框架在针对培训生遭受暴力的文献中，首次呼吁专业美德中的自我牺牲精神，并对其进行了合理的限制。
我们的搜索未发现之前有任何出版物专门探讨暴力侵害培训生的伦理挑战。我们确定了一些有关暴力事件的报告及其局限性。该伦理框架基于围产期医学专业伦理中的自我牺牲专业美德。这一美德使培训生有责任接受合理的生命和健康风险，但不能接受不合理的风险。社会有责任保护培训生免受这些不合理的风险。医疗教育工作者应保护个人安全。学术领导者应制定和实施政策，为培训生提供这种保护。政府机构应提供有效的执法，并对那些被指控对培训生实施暴力的人进行公正审判。国际社会应颁布可适用于培训生遭受暴力事件的伦理声明。通过保护培训生，围产期医学领域的医疗教育工作者和学术领导者也将保护孕妇、胎儿和新生儿患者。
本文首次提供了一个基于自我牺牲专业美德及其合理限制的伦理框架，旨在为围产期医学领域的医疗教育工作者和学术领导者提供指导，帮助他们应对针对培训生的暴力行为所带来的伦理挑战。
