李骥;尤雯;刘爽;阮戈冲;徐天铭;张润丰;张新庆;钱家鸣;
LI Ji;YOU Wen;LIU Shuang;RUAN Ge-chong;XU Tian-ming;ZHANG Run-feng;ZHANG Xin-qing;QIAN Jia-ming;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;School of Clinical Medicine,Chinese Academy of Medical Sciences & Peking Union Medical College;School of Humanities and Social Sciences,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院消化内科
• 2:中国医学科学院北京协和医学院临床医学院
• 3:中国医学科学院北京协和医学院人文和社会科学学院

摘要(Abstract)：

临床实践教学过程中经常遇到棘手的伦理问题,如医学生的受教育权与患者"最佳利益"之间的冲突。正确认识这一临床伦理问题,并制定恰当的应对方案,有助于临床带教医师、医学生从容应对该矛盾,并提高患者满意度。本文以"患者拒绝医学生操作"为例,从临床伦理学角度,基于医疗适用性、患者偏好、生命质量及情境特征"四主题理论"模式进行评估,提炼核心伦理问题,并结合国内外文献及自身经验提出应对策略和建议,以期为临床教学提供参考和帮助。
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.

关键词(KeyWords)： 临床伦理学;医学教育;患者偏好;医患共同决策
clinical ethics;medical education;preferences of patients;shared decision making

Abstract:

Keywords:

基金项目(Foundation): 北京协和医学院2017年教学质量工程项目(2017zlgc0110)~~

作者(Authors): 李骥;尤雯;刘爽;阮戈冲;徐天铭;张润丰;张新庆;钱家鸣;
LI Ji;YOU Wen;LIU Shuang;RUAN Ge-chong;XU Tian-ming;ZHANG Run-feng;ZHANG Xin-qing;QIAN Jia-ming;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;School of Clinical Medicine,Chinese Academy of Medical Sciences & Peking Union Medical College;School of Humanities and Social Sciences,Chinese Academy of Medical Sciences & Peking Union Medical College;

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