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哲学教育与神学教育对临床医学伦理学家道德发展的影响。

The influence of philosophical versus theological education on the moral development of clinical medical ethicists.

作者信息

Self D J, Skeel J D, Jecker N S

机构信息

Department of Humanities in Medicine, Texas A&M University Health Science Center College of Medicine, College Station.

出版信息

Acad Med. 1993 Nov;68(11):848-52. doi: 10.1097/00001888-199311000-00013.

Abstract

PURPOSE

Because of the increasing involvement of clinical medical ethicists in patient care and the resultant controversy over the appropriate background, training, and certification of clinical ethicists, this study was designed to investigate whether different educational backgrounds (philosophical versus theological) affected the moral reasoning of clinical ethicists and their orientations toward justice or care.

METHOD

From 1987 through 1990, extensive oral interviews were conducted with 50 clinical medical ethicists (26 philosophers and 24 theologians) who were at 32 medical centers in 14 states from all sections of the United States. The interviews were used to gather selected demographic characteristics about the ethicists (age, gender, and educational background) as well as to determine the ethicists' scores for stages of moral reasoning and for moral orientation. Polyserial correlations and multivariant analyses were then performed between the demographic characteristics and the data on moral reasoning and moral orientation.

RESULTS

The philosophers and theologians were found not to be significantly different (p > .05) in their moral reasoning skills in terms of either moral stage score or weighted average score. Similarly, the philosophers and theologians were found not to be significantly different in their moral orientations toward justice or care in terms of recognition, predominance, or alignment. No significant relationship was found between age or gender and moral reasoning or moral orientation.

CONCLUSION

Based on the results of this study, it appears that clinical medical ethicists, whether philosophers or theologians, are a fairly homogeneous group with regard to their moral development, in terms of both their stages of moral reasoning and their moral orientations toward justice and care.

摘要

目的

鉴于临床医疗伦理学家越来越多地参与患者护理,以及由此引发的关于临床伦理学家适当背景、培训和认证的争议,本研究旨在调查不同教育背景(哲学与神学)是否会影响临床伦理学家的道德推理及其对正义或关怀的取向。

方法

从1987年到1990年,对来自美国各地14个州32个医疗中心的50名临床医疗伦理学家(26名哲学家和24名神学家)进行了广泛的口头访谈。访谈用于收集伦理学家的选定人口统计学特征(年龄、性别和教育背景),并确定伦理学家在道德推理阶段和道德取向方面的得分。然后对人口统计学特征与道德推理和道德取向数据进行多系列相关分析和多变量分析。

结果

就道德阶段得分或加权平均分而言,哲学家和神学家在道德推理技能方面没有显著差异(p>.05)。同样,在对正义或关怀的道德取向方面,就认知、主导或一致性而言,哲学家和神学家也没有显著差异。年龄或性别与道德推理或道德取向之间未发现显著关系。

结论

基于本研究结果,就道德发展而言,无论是哲学家还是神学家,临床医疗伦理学家在道德推理阶段以及对正义和关怀的道德取向方面似乎都是一个相当同质化的群体。

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