28th European Conference on Philosophy of Medicine and Health Care, Bioethics and Biopolitics, Debrecen, Macaristan, 27 - 30 Ağustos 2014, ss.132-133
28th EUROPEAN CONFERENCE ON PHILOSOPHY OF
MEDICINE AND HEALTH CARE
“Bioethics and
Biopolitics”, 27 – 30 August,
2014, Debrecen (Hungary), Oral Paper Abstract
"ETHICAL REASONING IN CLINICAL YEARS:
ETHICS ROUNDS, ACIBADEM UNIVERSITY EXPERIENCE"
Yesim Isil Ulman*, Pinar Topsever**, Kevser Vatansever*** Fatih Artvinli****
Aim:
The ethic rounds aim to develop ethical sensitivity and professional motivation
during the clerkship period by fostering professional and ethical values in
clinical and ethical decision-making in daily practice; to integrate ethical formation
in preclinical years with the practice based clinical experience with actual
cases.
Materials and methods:
Ethic Rounds are featured within the internal medicine clinical clerkship which
takes place four times within the academic year, rotating groups of students. Additionally,
Forensic Medicine inserted Ethics Rounds in the Clerkship curriculum in the 5th
year. Thus, five ethics rounds are organized.
The
ethics rounds are organized in an interdisciplinary manner with clinicians from
different branches. Presented cases may feature different themes working
together with the department of medical ethics. The clinicians are asked to choose a case
representing an ethical dilemma from their daily clinical practice. They are
provided with a guide to prepare this case for discussion with the students
during the ethics round. The format of this guide includes a short case
description, formulation of the problem and identification of the related
ethical values and/or principles. The clinicians are also provided with a short
theoretical outline about ethical values and principles.
Results:
The
students described the ethics rounds as beneficial, remindful, stimulating, and
proposed repeating these exercises in each clinical year. They think this
practice has stabilized what they have already learned in ethics lessons at
preclinical years. They find it instructive to think over the clinical case in
the perspective of ethical issues and legal practice. They liked that the cases
were chosen from the real daily clinical practice. They enjoyed to express
their ideas and views actively and in an open way with peers and clinicians and
instructors. They commented that they glean ideas, take lessons from the
clinicians’ experiences for managing difficult patient encounters and breaking
bad news.
The
clinicians find the ethics rounds beneficial. They think that the systematic
real life experience such as ethics rounds at undergraduate level will be quite
helpful for students to get ready for coping with the ethical dilemmas and
conflicts in professional life.
Conclusion: Ethics Rounds is sustainable and compatible with the vertical integration in medical education in order to enhance professionalism.
Sources:
1)
M Svantesson, R Löfmark, H Thornsén, K Kallenberg, G Ahlström, “Learning a way through ethical problems:
Swedish nurses’ and doctors’ experiences from one model of ethics rounds”, J Med Ethics 2008;34:399–406.
2) Fryer-Edwards K, Wilkins D, Baernstein A, Braddock CH.
Bringing Ethics Education to the Clinical Years: Ward Ethics Sessions at the
University of Washington, Academic
Medicine, 2006; 81(7): 626-631.
* PhD, Prof of History of Medicine and Ethics, Acibadem Univ. School of
Medicine, Istanbul TRyesimul@yahoo.com
** MD, Assoc. Prof. of Family Medicine, Acibadem Univ. School of Medicine,
Istanbul TR
*** MD, PhD, Assist. Prof. of Public Health and Medical Education, Ege
Univ. School of Medicine, Izmir TR
**** PhD, Assist. Prof. of History of Medicine and Ethics,
Acibadem Univ. School of Medicine, Istanbul TR