Asai A, Kishino M, Fukui T, Masano T
Department of General Medicine and Clinical Epidemiology, Kyoto University School of Medicine, Aichi, Japan.
Med Educ. 1998 Jan;32(1):100-4. doi: 10.1046/j.1365-2923.1998.00171.x.
The objective of this paper was to investigate what kind of postgraduate education in medical ethics medical residents in Japan receive and what they want for ethical education and guidelines. Sixteen teaching hospitals that provide a general internal medicine residency programme in Japan were used (145 medical residents working at the departments of general internal medicine). A total of 114 residents participated in our survey, yielding a response rate of 79%. Of these, 28% received education in medical ethics more than once a month; 24% were offered it only when ethical problems were involved in actual patient care; and 18% answered that opportunities were very rare and sporadic. A full 30% had received no education in medical ethics at all. Many residents (71%) learned medical ethics from individual supervising doctors. A majority of the residents had been taught about informed consent (79%) and doctor-patient relationships (54%); 46% had learned about the appropriateness of truth telling and of ethical decisions regarding withholding and withdrawing a life-sustaining treatment, respectively. A total of 85 residents (75%) wanted to have more comprehensive education in medical ethics, 13% could not decide, and 12% did not want it. Many (66%) thought that both doctors and ethical philosophers should jointly teach medical ethics in postgraduate residency programmes. The results suggest that many residents desire more comprehensive and interdisciplinary education in medical ethics and educators in Japan should aim to develop education programmes to meet these desires.
本文的目的是调查日本内科住院医师接受何种医学伦理学研究生教育，以及他们对伦理教育和指导方针的期望。研究使用了日本16家提供普通内科住院医师培训项目的教学医院（145名在内科工作的住院医师）。共有114名住院医师参与了我们的调查，回复率为79%。其中，28%的人每月接受一次以上的医学伦理学教育；24%的人仅在实际患者护理中涉及伦理问题时才接受相关教育；18%的人回答说相关机会非常罕见且零散。整整30%的人根本没有接受过医学伦理学教育。许多住院医师（71%）从个别指导医生那里学习医学伦理学。大多数住院医师学习过知情同意（79%）和医患关系（54%）；分别有46%的人学习过告知真相的适当性以及关于维持生命治疗的 withholding 和 withdrawing 的伦理决策。共有85名住院医师（75%）希望接受更全面的医学伦理学教育，13%的人无法决定，12%的人不希望接受。许多人（66%）认为医生和伦理哲学家应在研究生住院医师培训项目中共同教授医学伦理学。结果表明，许多住院医师渴望接受更全面、跨学科的医学伦理学教育，日本的教育工作者应致力于制定教育计划以满足这些需求。
