醫學生所見精神科日常醫療倫理問題

本研究之目的在於從醫學生的角度與觀點，探討精神科日常醫療的倫理問題。本研究以某敎學醫院之見習醫師為研究對象；以其在精神科之見習課程中安排醫學倫理小組討論課程，並根據其所繳交—醫學倫理困境—書面報告進行内容分析。結果顯示醫學生認為精神科日常醫療最常遭遇的倫理課題依次為：「醫病關係」、「患者自主性」、「以病患為教材及醫師、醫學生之角色」、「保密原則」、「公正原則和醫療資源分配」、「知情同意」、「與家屬之互動」、「與其他專業團體之互動」、「馈贈行為」、「其他未分類之議題」等10項。本研究之結論：學生提出的倫理議題具有本土的特色，與其他國家醫學生所見不同；建議醫學倫理敎育課程，應加強醫學生所忽略的「行善原則」、「勿害原則」相關倫理觀念。

關鍵字

精神科日常醫療倫理；醫學生；醫學倫理；醫學教育

並列摘要

The purpose of this paper is to explore the everyday ethical dilemmas encountered with in the psychiatric setting from the perspective of medical students. In the 1997-1998 academicyear, 195 medical students undergoing a rotation clerkship in the Psychiatric Department of a medical college hospital were recruited for this study. The participants were requested to note ethical problems they encountered; a short essay was required at the end of their rotation. Content analysis was used to classify the ethical issues mentioned. The results revealed that the main focus points were on the doctor-patient relationship, autonomy, patients as teaching materials and roles of students and physicians. The content were also rich in culturally relevant materials, e.g. red envelope and interaction with family member. In conclusion, some differences are noted in comparison with the four principles of medical ethics and with the perspectives of western medical students. The principle of beneficence and the principle of nonmaleficence should be emphasized in the medical ethics education program.

並列關鍵字

everyday psychiatric practice ethics ； medical student ； medical ethics ； medical education

國際替代計量

醫學生所見精神科日常醫療倫理問題

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