医学伦理学教学的四种理念分析

Analysis of Four Concepts in Medical Ethics Teaching

根据医学伦理学的学科性质,可以将医学伦理学的教学理念分为四种不同的形态,分别是知识型教学、技能型教学、观念型教学和美德型教学。这四种基本理念的差异构成了医学伦理学内在的分歧与争论,不同的专业教师、专家学者究竟采取什么样的教学方式,取决于他们站在什么样的角度来看待医学伦理学。知识型教学重在传授客观而确定的知识,将伦理学打扮成类似自然科学那种明确固定的知识点来进行传授。技能型教学重在培养学生的伦理分析、道德推理和逻辑思考能力,帮助医生更好地作出临床决策,解决临床实践活动中的各种道德难题。观念型教学重在训练学生抽象的哲学思辨和道德思考能力,这是因为医学伦理学属于伦理学,而伦理学则属于哲学的二级学科,它基本上属于观念型的研究范式。美德型教学则旨在提高学生的医德水平和职业精神,这种观念不仅历史悠久,而且长期以来一直占据着医学伦理学的中心。然而这四种不同的教学形式各有利弊,且都存在严重的不足。知识型教学虽然向学生传授了某些确定的知识点,但这些看似确定的东西却往往是未经反省的,且很容易给学生造成死记硬背的假象。技能型教学较好地抓住了医学伦理知识的技术性特点,但仍然需要将这种技能与临床实践紧密结合,才能有效解决实践中的道德难题。观念型教学虽然抓住了医学伦理的哲学性质,但容易陷入抽象的思辨,使学生难以理解和把握。而美德型教学虽然符合人们对于医学职业的朴素认知,然而它不仅面临着美德是否可教的理论难题,而且面临如何去培养医学生美德的实践难题。在目前的学科体系和话语体系之中,最有效的路径是选择综合性的授课方式,综合运用两种以上的方式来开展教学活动,以产生较好的预期效果。

According to the nature of medical ethics,the teaching concepts of medical ethics can be divided into four different forms:knowledge-based teaching,skill-based teaching,concept-based teaching and virtue-based teaching.The differences of these four basic concepts constitutes the internal differences and debates of medical ethics.The teaching methods adopted by different professional teachers,experts and scholars depends on the perspective from which they view treat medical ethics.Knowledge-based teaching focuses on imparting objective and definite knowledge,and dressing ethics as a clear and fixed knowledge point similar to natural science.Skill-based teaching pays attention to cultivating students ability of ethical analysis,moral reasoning and logical thinking,to help doctors make better clinical decisions and solve various moral problems in clinical practice.Conceptual teaching focuses on the training of students abstract philosophical and moral thinking ability,as medical ethics belongs to ethics,while ethics belongs to the secondary discipline of philosophy,which basically is a conceptual research paradigm.Virtue-teaching aims to improve students medical ethics and professionalism,which has a long history and has been the center of medical ethics for a long time.However,these four different teaching forms have their own advantages and disadvantages,and all of them have serious shortcomings.Although knowledge-based teaching instructs certain knowledge points to students,these seemingly certain things are often unreflected,and it is easy to give students the false impression of rote learning.Skill-based teaching can greatly grasp the technical characteristics of knowledge of medical ethics,but it is still necessary to combine the skill with clinical practice to effectively solve the moral problems in practice.The concept-teaching has grasped the philosophical nature of medical ethics.However,it is effortless to fall into abstract speculation,which makes it difficult for students to understand and grasp.Though the virtue-teaching conforms to people s cognition of medical profession,it faces not only the theoretical problems that whether virtue can be taught,but also practice dilemma that how to cultivate virtue of medical students.In the current subject system and discourse system,the most effective way is to choose a comprehensive teaching method and use more than two ways to carry out teaching activities,so as to produce better expected results.