BENEFICENCE IS THE HIGHEST MORAL IMPERATIVE OF A DOCTOR DEALING WITH THE POOR QUALITY OF PATIENT AUTONOMY

Veronica Nadya Puteri Nandifa; Yeremias Jena; Satya Joewana

doi:10.22146/jpki.44511

BENEFICENCE IS THE HIGHEST MORAL IMPERATIVE OF A DOCTOR DEALING WITH THE POOR QUALITY OF PATIENT AUTONOMY

https://doi.org/10.22146/jpki.44511

Veronica Nadya Puteri Nandifa^(1*), Yeremias Jena⁽²⁾, Satya Joewana⁽³⁾

(1) 1Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Katolik Indonesia Atma Jaya, Jakarta - INDONESIA
(2) Departemen Etika, Fakultas Kedokteran dan Ilmu Kesehatan Universitas Katolik Indonesia Atma Jaya, Jakarta - INDONESIA
(3) Departemen Ilmu Kesehatan Jiwa, Fakultas Kedokteran dan Ilmu Kesehatan Universitas Katolik Indonesia Atma Jaya, Jakarta - INDONESIA
(*) Corresponding Author

Abstract

Background: Doctors need good moral reasoning to solve moral issues that cause dilemmas in decision making. But researches on medical students suggest that there was no significant moral development in four-year length of studies and there was a moral regression instead since the students entered clinical years. The aim of this study is to find out the description about Duration of Study in Medical School and Moral Reasoning among Medical Students.

Methods: This is a descriptive study using cross-sectional design. Samples were medical students of Atma Jaya Catholic University of Indonesia which enrolled at the year of 2012 – 2016. Duration of study was determined by the school year and moral reasoning was determined based on the domain of autonomy, beneficence-non maleficence, justice and other contextual features found in 3 vignettes of moral problems.

Results: Students class of 2012-2016’s moral reasoning dominantly identified the principle of beneficence and non-maleficence. In vignette 1, autonomy, justice and other contextual features also had a quite high answer percentage. Overall students’ moral reasoning is similar between school year, but there was slight difference in clinical students. There was no difference in moral reasoning between male and female.

Conclusion: Medical Students respect the principles of beneficence and non-maleficence. There is a slight difference in moral reasoning between the preclinical and clinical students. There was no difference in moral reasoning between male and female.

Keywords

moral reasoning, school year, medical students, biomedical ethics

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References

Rose JD. Development of Moral Reasoning at a Higher Education Institution in Nigeria. ELJ. 2012;5(1):81-101 [internet] http://www.regent.edu/acad/global/publications/elj/vol5iss1/ELJ_Vol5No1_Rose_pp81-101.pdf [ 24 Okt 2017].
Hren D, Marušić M, Marušić A. Regression of Moral Reasoning during Medical Education: Combined Design Study to Evaluate the Effect of Clinical Study Years. PLoS ONE [Internet]. 2011;6(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068134/ [20 Okt 2017];
Patenaude J, Niyonsenga T, Fafard D. Changes in students’ moral development during medical school: A cohort study. Can Med Assoc J CMAJ Ott. 2003;168(7):840–4.
Murrell VS. The failure of medical education to develop moral reasoning in medical students. Int J Med Educ. 2014;5:219–25.
Sisola SW. Moral Reasoning as a Predictor of Clinical Practice: The Development of Physical Therapy Students across the Professional Curriculum. J Phys Ther Educ. 2000;14(3):26.
Doyle E, O’Flaherty J. The impact of education level and type on moral reasoning. Ir Educ Stud. 2013;32(3):377–93.
Sheehan S, Robbins A, Porter T, Manley J. Why does moral reasoning not improve in medical students? Int J Med Educ. 2015;6:101–2.
Akabayashi A, Slingsby BT, Kai I, Nishimura T, Yamagishi A. The development of a brief and objective method for evaluating moral sensitivity and reasoning in medical students. BMC Med Ethics. 2004;5:1.
Takaschima AKK, Sakae TM, Takaschima AK, Takaschima R dos ST, Lima BJSB de, Benedetti RH. Ethical and legal duty of anesthesiologists regarding Jehovah’s Witness patient: care protocol. Braz J Anesthesiol Engl Ed. 2016;66(6):637–41.
Muramoto O. Bioethical aspects of the recent changes in the policy of refusal of blood by Jehovah's Witnesses. BMJ. 2001;322:37–9
Chen YY, Tsai SL, Yang CW, Ni YH, Chang SC. The ongoing westernization of East Asian biomedical ethics in Taiwan. Soc Sci Med. 2013;78:125–9.
Macer DRJ. Encyclopedia of the Human Genome: Bioethics in Asia. Tsukuba:Nature MacMillan;2003. Hlm 277-280
Douglas SM, Dahnke MD. Creating an ethical environment for parents and health providers dealing with the treatment dilemmas of neonates at the edge of viability. Journal of Neonatal Nursing. 2013;19(1):33-37.
Bertens Bertens K. Etika Biomedis. Edisi ke-3. Yogyakarta : Kanisius; 2014
Hébert PC, Meslin EM, Dunn EV. Measuring the ethical sensitivity of medical students: a study at the University of Toronto. J Med Ethics. 1992;18(3):142–7.