Meyer Elaine C, Lamiani Giulia, Uveges Melissa, McLeod-Sordjan Renee, Mitchell Christine, Truog Robert D, Marron Jonathan M, Kennedy Kerri O, Ritholz Marilyn, Teti Stowe Locke, Milliken Aimee B
Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA.
Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.
HEC Forum. 2025 Jun;37(2):179-201. doi: 10.1007/s10730-024-09533-6. Epub 2024 Jul 9.
Bioethics conjures images of dramatic healthcare challenges, yet everyday clinical ethics issues unfold regularly. Without sufficient ethical awareness and a relevant working skillset, clinicians can feel ill-equipped to respond to the ethical dimensions of everyday care. Bioethicists were interviewed to identify the essential skills associated with everyday clinical ethics and to identify educational case scenarios to illustrate everyday clinical ethics. Individual, semi-structured interviews were conducted with a convenience sample of bioethicists. Bioethicists were asked: (1) What are the essential skills required for everyday clinical ethics? And (2) What are potential educational case scenarios to illustrate and teach everyday clinical ethics? Participant interviews were analyzed using qualitative content analysis. Twenty-five (25) bioethicists completed interviews (64% female; mean 14.76 years bioethics experience; 80% white). Five categories of general skills and three categories of ethics-specific skills essential for everyday clinical ethics were identified. General skills included: (1) Awareness of Core Values and Self-Reflective Capacity; (2) Perspective-Taking and Empathic Presence; (3) Communication and Relational Skills; (4) Cultural Humility and Respect; and (5) Organizational Understanding and Know-How. Ethics-specific skills included: (1) Ethical Awareness; (2) Ethical Knowledge and Literacy; and (3) Ethical Analysis and Interaction. Collectively, these skills comprise a Toolbox of Everyday Clinical Ethics Skills. Educational case scenarios were identified to promote everyday ethics. Bioethicists identified skills essential to everyday clinical ethics. Educational case scenarios were identified for the purpose of promoting proficiency in this domain. Future research could explore the impact of integrating educational case scenarios on clinicians' ethical competencies.
生物伦理学让人联想到戏剧性的医疗保健挑战，然而日常临床伦理问题却经常出现。如果没有足够的伦理意识和相关的工作技能，临床医生可能会觉得自己没有能力应对日常护理中的伦理问题。我们采访了生物伦理学家，以确定与日常临床伦理相关的基本技能，并确定用于说明日常临床伦理的教育案例场景。我们对生物伦理学家的便利样本进行了个人半结构化访谈。我们问生物伦理学家：（1）日常临床伦理所需的基本技能有哪些？（2）有哪些潜在的教育案例场景可以说明和教授日常临床伦理？我们使用定性内容分析法对参与者的访谈进行了分析。25位生物伦理学家完成了访谈（64%为女性；生物伦理学平均经验为14.76年；80%为白人）。我们确定了日常临床伦理所需的五类通用技能和三类特定伦理技能。通用技能包括：（1）核心价值观意识和自我反思能力；（2）换位思考和共情在场；（3）沟通和关系技能；（4）文化谦逊和尊重；（5）组织理解和实际操作能力。特定伦理技能包括：（1）伦理意识；（2）伦理知识和素养；（3）伦理分析和互动。这些技能共同构成了日常临床伦理技能工具箱。我们确定了教育案例场景以促进日常伦理。生物伦理学家确定了日常临床伦理所需的技能。我们确定教育案例场景的目的是提高在该领域的熟练程度。未来的研究可以探索整合教育案例场景对临床医生伦理能力的影响。
