医学生“道德困境”选择的倾向性研究  

A Study on the Tendency of Medical Students Choice of Moral Dilemma

作　　者：任洪磊 赵通 施莉莉[2] 蔡雨阳[1] REN Honglei;ZHAO Tong;SHI Lili;CAI Yuyang(School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Dean s Office,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院公共卫生学院,上海200025 [2]上海交通大学医学院附属新华医院院长办公室,上海200092

出　　处：《中国医学伦理学》2022年第10期1118-1123,共6页Chinese Medical Ethics

基　　金：国家社会科学基金项目“基于卫生热线大数据视角的医患关系研究”(17BSH056);上海交通大学教学发展基金“医学伦理情景案例教学实践与优化探索”(CTLD21J0078);上海交通大学医学院一流本科课程建设重点项目(2021/卫生经济与政策)。

摘　　要：目的运用经典道德两难情景案例,调研医学生在面临道德两难困境时的选择倾向,分析其面临“道德两难”困境时的认知现状与特点,以期为优化医学伦理教学案例提供有效启示。方法采用电子问卷对上海交通大学医学院的771名医学生进行调查,运用SPSS 22.0进行统计描述及统计分析。结果在急诊室的医生和转轨场景中,医学生倾向于最大幸福原则,在环轨场景和人行天桥场景中,倾向于道义论原则;在环轨场景和人行天桥场景中,女生比男生、本科生比研究生更倾向于道义论原则,且差异有统计学意义(P<0.05)。结论医学生虽在不同场景中的道德倾向不同,但整体上不太认可牺牲一人救五人的做法。尤其当更苛刻的牺牲条件造成更大的道德压力时,绝大部分医学生在功利主义和道义论原则之间会倾向后者。Objective:Using classic moral dilemma cases,this paper investigates the choice tendency of medical students when facing the moral dilemma,and analyzes their cognitive status and characteristics when facing the moral dilemma,in order to provide effective enlightenment for optimizing the teaching cases of medical ethics.Method:771 medical students in Shanghai Jiao Tong University School of Medicine were investigated by electronic questionnaire and SPSS 20.0 for statistical description and statistical analysis.Result:In the emergency room doctors and transition scenes,medical students tend to the principle of maximum happiness,and in the ring track scene and pedestrian overpass scene,they tend to the principle of deontology;In the loop track scene and pedestrian overpass scene,boys are more inclined to deontological principles than girls,and undergraduates are more inclined to deontological principles than postgraduates,and the difference is statistically significant(P<0.05).Conclusion:Although medical students have different moral tendencies in different scenes,they generally do not agree with the practice of sacrificing one person to save five people.Especially when more rigorous sacrifice conditions cause greater moral pressure,the vast majority of medical students will tend to the latter between utilitarianism and deontological principles.

关 键 词：医学教育 道德困境 道义论 功利论 

分 类 号：R395[哲学宗教—心理学]