目的 为了了解医学研究生伦理认知和论证能力的现状,探讨医学人文教育中,基于生命伦理学案例定量评估医学研究生伦理分析论证能力的方法。方法 基于子宫移植手术引发的伦理问题,借助自行设计的评估表对340名中国医学科学院2015级硕士研究生就伦理认知和论证能力现状进行评估并对结果进行归纳、整理和统计学分析。结果 有72.4%(246/340)的研究生对子宫移植术持支持态度,并较好地理解和应用案例所涉及的知情同意、受益最大化、风险最小化等伦理原则。多因素Logistic回归分析结果显示,认识到子宫移植术带来的收益、同时类似移植手术认知程度较高的研究生更容易给出明确的支持态度,然而认识到手术可能存在的危险的更容易给出明确的反对态度。结论 参与研究的研究生具备基本的伦理论证能力,但是仍然需要强化。定量分析方法可以较为客观准确地评估研究生的伦理论证能力,为确定教学侧重点进而提高教学质量提供依据,未来需要进一步探索并完善测量工具。
Objective To investigate the capacity of medical postgraduates' ethical analysis and the method of quantitative statistical analysis about bioethical case.Methods The ethical issues raised in uterine transplantation was taken into consideration. Self-designed questionnaire and quantitative statistical method is used to codify and analyze 340 medical postgraduates' written response about ethical perception of the uterine transplantation.Results There were 72.4%(246/340)students who held the supportive attitude toward the uterus transplantation, and had better understood about the ethical principles such as informed consent, max-benefit and min-risk. Logistic multivariate analysis found that the object who had realized the benefits of uterine transplantation and a higher degree of awareness about similar transplant was more likely to support the case. However, those who had the awareness of the probable risks during surgery were more likely to be opposed to it.Conclusions The investigated medical postgraduates had the basic level of ethical perception, meanwhile further improve was essential. Quantitative analysis was accurate method to evaluate medical students' ethical ability, and provided scientific basis for the teaching improving. However, further exploration of the measurement tools was necessary in the future.
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