Clarify and Resolve Ethical Issues in the Teaching of Clinical Practice Based on the Four-topics Theory——An Example of Patients' Refusal to the Practice of Medical Students

LI Ji; YOU Wen; LIU Shuang; RUAN Ge-chong; XU Tian-ming; ZHANG Run-feng; ZHANG Xin-qing; QIAN Jia-ming

doi:10.12290/xhyxzz.20200135

Volume 12 Issue 2

May 2021

Turn off MathJax

Article Contents

Abstract

References

Medical Journal of Peking Union Medical College Hospital > 2021 > 12(2): 282-286. > DOI: 10.12290/xhyxzz.20200135

LI Ji, YOU Wen, LIU Shuang, RUAN Ge-chong, XU Tian-ming, ZHANG Run-feng, ZHANG Xin-qing, QIAN Jia-ming. Clarify and Resolve Ethical Issues in the Teaching of Clinical Practice Based on the Four-topics Theory——An Example of Patients' Refusal to the Practice of Medical Students[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(2): 282-286. DOI: 10.12290/xhyxzz.20200135

Citation:

PDF (413 KB)

Clarify and Resolve Ethical Issues in the Teaching of Clinical Practice Based on the Four-topics Theory——An Example of Patients' Refusal to the Practice of Medical Students

1.
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2.
School of Clinical Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
3.
School of Humanities and Social Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds:

Education Reform Projects of Peking Union Medical College 2017zlgc0110

More Information

Corresponding author:
QIAN Jia-ming Tel: 86-10-69155019 E-mail: qianjiaming1957@126.com
Received Date: May 17, 2020
Accepted Date: June 21, 2020
Available Online: January 31, 2020
Issue Publish Date: May 29, 2021

Graphical Abstract

Abstract

Abstract

This article addressed the ethical issues during teaching medical students the clinical practice, which focused on the conflict between the best interest of patients and the obligation to accept practice of medical students. It firstly evaluated the ethical issue based on the "four topics", which included medical indications, patients' preferences, quality of life, and contextual features to clarify the core clinical ethical problem. Then it provided suggestions based on the viewpoints in literature as well as the authors' own experiences, including respecting patients' autonomy and right of informed consent, and improving physician-patient communica- tion. Based on the above discussion, this article provided some insights into how to solve this kind of ethical problem for mentors and medical students.
- clinical ethics,
- medical education,
- preferences of patients,
- shared decision making

FullText(HTML)

References (14)

References

[1]	张新庆. 医患"共享决策" 核心概念解析[J]. 医学与哲学, 2017, 38: 12-15. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201710007.htm Zhang XQ. Core concept analysis of shared decision-marking between physicians and patients[J]. Yi Xue Yu Zhe Xue, 2017, 38: 12-15. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201710007.htm
[2]	Jagsi R, Lehmann LS. The ethics of medical education[J]. BMJ, 2004, 329: 332-334. DOI: 10.1136/bmj.329.7461.332
[3]	马伟, 黄瑞宝. 临床实践教学中的权责失衡及出路——基于《医学教育临床实践管理暂行规定》视角的分析[J]. 医学与哲学, 2015, 36: 68-70. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201511018.htm Ma W, Huang RB. Legal dilemma and resolution to clinical practice teaching: based on the perspective of interim provisions of clinical practice on medical education[J]. Yi Xue Yu Zhe Xue, 2015, 36: 68-70. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201511018.htm
[4]	宋爽, 曹逸涵, 傅麒宁, 等. 中外医学生临床实习身份问题调查及对比分析[J]. 基础医学与临床, 2019, 1: 144-148. DOI: 10.3969/j.issn.1001-6325.2019.01.036 Song S, Cao YH, Fu QN, et al. Contrastive study on identity issues of medical students in China and abroad during clinical clerkship[J]. Ji Chu Yi Xue Yu Lin Chuang, 2019, 1: 144-148. DOI: 10.3969/j.issn.1001-6325.2019.01.036
[5]	Siegler M, Pellegrino ED, Singer PA. Clinical medical ethics[J]. J Clin Ethic, 1990, 1: 5-9.
[6]	Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics: A practical approach to ethical decisions in clinical medicine[M]. 8th ed. New York: McGraw-Hill Education, 2015: 7-11.
[7]	张渊. 患者偏好与医患共同决策[J]. 协和医学杂志, 2019, 10: 679-684. DOI: 10.3969/j.issn.1674-9081.2019.06.022 Zhang Y. Patient preference and shared decision making[J]. Xie He Yi Xue Za Zhi, 2019, 10: 679-684. DOI: 10.3969/j.issn.1674-9081.2019.06.022
[8]	Ousseine YM, Durand MA, Bouhnik AD, et al. Multiple health literacy dimensions are associated with physicians' efforts to achieve shared decision-making[J]. Patient Educ Couns, 2019, 102: 1949-1956. DOI: 10.1016/j.pec.2019.05.015
[9]	AMA. Medical Student Involvement in Patient Care: Code of Medical Ethics Opinion 9.2.1[EB/OL]. [2020-05-17]. https://www.ama-assn.org/delivering-care/ethics/medical-student-invol-vement-patient-care.
[10]	卫生部, 教育部. 医学教育临床实践管理暂行规定[J]. 中国社区医学, 2009, 1: 10-11. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201511018.htm National Health Commission of the People's Republic of China, Ministry of Education of the People's Republic of China. Interim provisions on the management of clinical practice in medical education[J]. Zhongguo She Qu Yi Xue, 2009, 1: 10-11. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201511018.htm
[11]	刘静, 黄定, 戴远辉, 等. 医学生临床实践技能培养的改革与创新[J]. 继续医学教育, 2019, 33: 7-8. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY201909005.htm Liu J, Huang D, Dai YH, et al. Reform and innovation in clinical practice training of medical students[J]. Ji Xu Yi Xue Jiao Yu, 2019, 33: 7-8. https://www.cnki.com.cn/Article/CJFDTOTAL-JYJY201909005.htm
[12]	于泳浩, 张素品, 纪言文, 等. 模拟教学是医学教育的必然趋势[J]. 中国高等医学教育, 2009, 2: 37-39. https://www.cnki.com.cn/Article/CJFDTOTAL-ZOGU200902016.htm Yu YH, Zhang SP, Ji YW, et al. Simulation-based medical education-an inevitable trend in medical education[J]. Zhongguo Gao Deng Yi Xue Jiao Yu, 2009, 2: 37-39. https://www.cnki.com.cn/Article/CJFDTOTAL-ZOGU200902016.htm
[13]	Onder O, Padela AI. Faculty of responsibility: a key concept to cope with the ethical challenges medical students face[J]. J British Islamic Med Assoc, 2020, 4: 23-26. http://www.researchgate.net/publication/349945392_FACULTY_OF_RESPONSIBILITY_A_Key_Concept_to_Cope_with_The_Ethical_Challenges_Medical_Students_Face
[14]	Bailoor K, Adams MA. Medical Ethics in Endoscopy[J]. Am J Gastroenterol, 2020, 115: 158-159. DOI: 10.14309/ajg.0000000000000464

[1]	LU Yao, ZHANG Qian, CHENG Qianji, LIU Jianing, SUN Mingyao, NING Jinling, HUANG Jiajie, REN Simeng, ZHANG Wenzheng, LIU Yajie, DENG Xiyuan, TIAN Jinhui, LIU Jie, GE Long. Method for Developing Patient Decision Aid in China[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(6): 1422-1431. DOI: 10.12290/xhyxzz.2023-0608
[2]	LU Yao, LIU Jianing, WANG Mian, HUANG Jiajie, HAN Baojin, SUN Mingyao, CHENG Qianji, NING Jinling, GE Long. Artificial Intelligence in Shared Decision Making[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 661-667. DOI: 10.12290/xhyxzz.2023-0209
[3]	LIU Huan, HUANG Xiaoling, DAI Mengying, GUO Jiejie, GAO feng. Clinical Characteristics and Inflammatory Markers of Omicron BA.5.2 Variant Infection in Hospitalized Patients and Their Predictive Role in Disease Prognosis[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 1038-1045. DOI: 10.12290/xhyxzz.2023-0055
[4]	LIU Yuan, ZHAO Lin. Update and Interpretation of 2022 National Comprehensive Cancer Network Clinical Practice Guidelines for Gastric Cancer[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 999-1004. DOI: 10.12290/xhyxzz.2022-0271
[5]	ZHAO Zhe, TANG Yan, ZHOU Jingya, CHEN Xiaoguang, ZHANG Lei, CHEN Limeng, YUAN Tao. Analysis of Clinical Manifestations and Drug Therapies of Gitelman Syndrome[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(2): 277-286. DOI: 10.12290/xhyxzz.2021-0180
[6]	BAI Qiong, TANG Wen, WANG Yue. Analyze Clinical Ethical Issues in the Treatments of Chronic Renal Failure Based on Four Topics Theory: An Example of a Patient with Chronic Renal Failure Refusing Hemodialysis[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 1034-1038. DOI: 10.12290/xhyxzz.20200169
[7]	DAI Xiaomin, JIANG Lindi. Practice and Application of Four-topics Theory in Decision-making of Treatment Strategies in Patients with Rheumatic Diseases[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(4): 589-593. DOI: 10.12290/xhyxzz.20200171
[8]	XIE Jing, WU Dong, ZHANG Shu-yang. Public Health Ethics and Clinical Practice in the Context of Response to the Outbreak of an Infectious Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(1): 141-145. DOI: 10.12290/xhyxzz.20200249
[9]	Yuan ZHANG. Patient Preference and Shared Decision Making[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 679-684. DOI: 10.3969/j.issn.1674-9081.2019.06.022
[10]	Xia HONG. Shared Decision Making[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(3): 277-280. DOI: 10.3969/j.issn.1674-9081.2018.03.016

Cited By

Cited by

Periodical cited type(13)

1.	吴觉伦，申乐. 术后早期经口饮食在普通外科患者中的临床应用. 中华普通外科杂志. 2025(01): 70-74 .
2.	胡春华，赵晓艳，吴黎黎，陈红芽，许鑫，王古岩. 术中多模式镇痛对终末期头颈部癌症患者开腹胃造瘘术后早期恢复质量的影响：前瞻性随机对照研究. 协和医学杂志. 2024(02): 359-365 . 本站查看
3.	肖诗玉，李稀，王淼，官春燕. 1例老年高血压合并糖尿病患者并发食道异物迁移致咽后脓肿的个案护理. 医药前沿. 2024(02): 102-105 .
4.	罗晨，黄楚贤，赵冬琴，张昊，沈雨晴，沈玲. 腹腔镜结直肠癌根治术后患者早期下床活动方案的构建. 中华现代护理杂志. 2023(25): 3435-3440 .
5.	罗晨，沈玲，王传伟，顾佳妮，王瑾，赵黎，黄帅. 腹腔镜结直肠癌根治术后患者早期下床活动现状及影响因素. 上海交通大学学报(医学版). 2023(09): 1201-1210 .
6.	周太成，黄恩民. 切口疝腹腔镜IPOM修补七步法操作指南（2022版）. 中国普通外科杂志. 2022(04): 421-432 .
7.	李佳新，丁林，董彦杰，李茜. 深度肌松的临床研究应用进展. 西部医学. 2022(05): 770-774 .
8.	匡风霞，赵晓虹，韩宝佳，高成杰. 对控制机器人甲状腺癌根治术患者手术应激反应麻醉深度的探讨. 山东大学学报(医学版). 2022(05): 81-86 .
9.	胡帅，付佳，叶雨阳，金延武，赵鑫. 超声引导下腰方肌阻滞在腹腔镜疝修补术后加速康复中的应用. 山东医药. 2022(22): 65-68 .
10.	汪夏云，顾一帆，陈红，张琳，戴秀娟，汤爱洁，胡鑫淼，吴茜. 术前三联预康复对老年结直肠肿瘤病人康复的影响. 护理研究. 2022(18): 3233-3238 .
11.	卫佼佼，申乐. 术中静脉输注利多卡因在加速康复外科中的研究进展. 临床麻醉学杂志. 2022(10): 1097-1100 .
12.	袁秀婷，孙雪琴，詹晓青. 胃癌根治术后肺部感染列线图预测模型的建立. 循证护理. 2022(22): 3093-3098 .
13.	苏泽，赵国良，张智，侯晴晴，肖亿，覃鑫，孙兴. 加速康复外科理念在ERCP胰管支架置入术治疗胰腺假性囊肿中的应用. 河南医学高等专科学校学报. 2022(05): 533-536 .

Other cited types(5)

Get Citation

PDF

XML

Article Metrics

Article views (710) PDF downloads (70) Cited by(18)

Address：	Room 302,Third Floor,Building 7, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
Tel：	010-69154261/4262
E - mail：	medj@pumch.cn mjpumch@126.com
Copyright of website：	Editorial Office of Medical Journal of Peking Union Medical College Hospital

Clarify and Resolve Ethical Issues in the Teaching of Clinical Practice Based on the Four-topics Theory——An Example of Patients' Refusal to the Practice of Medical Students

Abstract

References

Related Articles

Cited by

Periodical cited type(13)

Other cited types(5)

Catalog

Article Metrics

Related

Clarify and Resolve Ethical Issues in the Teaching of Clinical Practice Based on the Four-topics Theory——An Example of Patients' Refusal to the Practice of Medical Students

Abstract

References

Related Articles

Cited by

Periodical cited type(13)

Other cited types(5)

Catalog

Article Metrics

Related

Export File

Citation

Format

Content