Marks S C, Bertman S L, Penney J C
Department of Cell Biology, Radiology, and Surgery, University of Massachusetts Medical School, Worcester, USA.
Clin Anat. 1997;10(2):118-22. doi: 10.1002/(SICI)1098-2353(1997)10:2<118::AID-CA8>3.0.CO;2-R.
In most medical schools, little curricular time is devoted to the art of medicine, and this is particularly evident with respect to death education. We make a case for including education on death and dying in medical schools, specifically its early introduction in the anatomy course. Studies indicate that whereas dissection of cadavers is an exciting discovery for most students, for many it is traumatic and if not addressed, students may use depersonalization and denial as their approach to suffering. The dissecting experiences in two different medical schools are described. The University of Massachusetts program developed in a traditional curriculum and explores humanistic issues with lectures and group discussions. Parallels are drawn between dissection and patient care, and coping styles are discussed openly. In the problem-based curriculum at Dalhousie Medical School, death and grief are discussed in the first week of medical school, and students are given information about the body donor program and support systems for students. This program is part of a longitudinal curriculum on death and dying. In both schools, students tour the dissecting rooms before the course begins and organize memorial events for body donors at the end of the academic year. These examples illustrate how death education can begin early in the medical curriculum and contribute to the development of practitioners who are sensitive to broader issues of human mortality.
在大多数医学院校，用于医学人文艺术的课程时间很少，这在死亡教育方面尤为明显。我们主张在医学院校开展死亡与临终教育，特别是在解剖课程中尽早引入。研究表明，虽然对大多数学生来说，解剖尸体是一项令人兴奋的发现，但对许多人来说却是痛苦的经历，如果不加以处理，学生可能会采用人格解体和否认的方式来应对痛苦。本文描述了两所不同医学院校的解剖经历。马萨诸塞大学的项目是在传统课程中开展的，通过讲座和小组讨论来探讨人文问题。解剖与患者护理之间建立了联系，并公开讨论了应对方式。在达尔豪斯医学院基于问题的课程中，在医学院的第一周就讨论了死亡和悲伤，并向学生提供了关于遗体捐赠项目和学生支持系统的信息。该项目是死亡与临终纵向课程的一部分。在这两所学校，学生在课程开始前参观解剖室，并在学年结束时为遗体捐赠者组织纪念活动。这些例子说明了死亡教育如何能在医学课程早期开始，并有助于培养对人类死亡等更广泛问题敏感的从业者。
