Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
Department of Medical Education, College of Medicine, Hanyang University, Seoul, Korea.
BMC Med Ethics. 2022 Mar 19;23(1):28. doi: 10.1186/s12910-022-00769-w.
The COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations.
This study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided informed consent and completed measures that assessed utilitarian moral views, cognitive reflections, cognitive reappraisal, and moral judgment.
The healthcare-affiliated students who scored higher on the instrumental harm subscale in the measurement of utilitarian moral views were more likely to endorse not only other-sacrificial actions but also self-sacrificial ones for the greater good in moral dilemma scenarios. In particular, those engaged in deliberative processes tended to make more self-sacrificial judgments. The mediation analysis also revealed that the effect of deliberative processes on self-sacrificial judgments was mediated by cognitive reappraisal.
These findings suggested that cognitive reappraisal through deliberative processes is involved when the students with utilitarian inclination make prosocial decisions, that it is necessary to consider both moral views and emotional regulation when admitting candidates, and that moral education programs are needed in the healthcare field.
COVID-19 大流行凸显了亲社会行为作为专业医疗保健核心能力的重要性。尽管医学生的工作应该以患者的最大利益为出发点，但在大流行背景下，需要更加关注医学生在处理可能与其义务相冲突的道德困境时的道德行为。
本研究于 2019 年春季对主修健康专业（医学、牙科和兽医学）的 271 名学生进行，所有参与者均提供了知情同意书，并完成了评估功利主义道德观、认知反思、认知重评和道德判断的测量。
在功利主义道德观测量中，在工具性伤害子量表上得分较高的医疗保健相关专业学生不仅更有可能支持为了更大的利益而采取其他牺牲行为，而且也更有可能支持自我牺牲行为。特别是，那些参与深思熟虑过程的人往往会做出更多的自我牺牲判断。中介分析还表明，深思熟虑过程对自我牺牲判断的影响是通过认知重评来介导的。
这些发现表明，当具有功利倾向的学生做出亲社会决策时，通过深思熟虑的认知重评会参与其中，在招生时需要同时考虑道德观点和情绪调节，并且在医疗保健领域需要开展道德教育项目。
