Moral Judgement along the Academic Training

Do Moral Judgments in Moral Dilemmas Make One More Inclined to Choose a Medical Degree?

The role of moral intuitions and moral judgments has become increasingly prominent in educational and academic choices. The present research aims to examine if the moral judgments elicited in sacrificial trolley dilemmas have a distinct pattern for the decisions made by junior medical students, in comparison to those of senior high school students. We work with this sample because it represents the population out of which medical students are recruited in the case of Bucharest, Romania. Our findings show that moral judgments are indeed a significant predictor for a respondent's status as medical students. This result, albeit with limitations, bears multiple practical implications, from developing empirically informed medical ethics courses in medical schools to evidence-based policy designs which consider factors such as morality alongside financial outcomes and incentives.

Ethical Healthcare Attitudes of Japanese Citizens and Physicians: Patient-Centered or Family-Centered?

BACKGROUND

In current Western medical ethics, patient-centered medicine is considered the norm. However, the cultural background of collectivism in East Asia often leads to family-centered decision-making. In Japan, prior studies have reported that family-centered decision-making is more likely to be preferred in situations of disease notification and end-of-life decision-making. Nonetheless, there has been a recent shift from collectivism to individualism due to changes in the social structure. Various personal factors have also been reported to influence moral decision-making. Therefore, this study examined whether the current trend in attitudes of healthcare decision-making in Japan is family-centered or patient-centered among the general public and physicians. In addition, the personal factors that influence this tendency were examined.

METHODS

Three vignettes on disease notification and two vignettes on decision-making during end-of-life care were created, and 457 members of the public and 284 physicians were asked about their attitudes (behavioral intentions) regarding these vignettes.

RESULTS

Approximately, 95% of physicians were patient-centered in explaining the patient's severe medical condition. However, approximately 80% of physicians emphasized the wishes of the family over patient wishes when making life-sustaining decisions. Nearly half the general public emphasized the patient's wishes in the explanation of a severe medical condition and in life-sustaining decisions. In both the public and physician groups, personal factors, particularly the presence or absence of a disease under treatment and prior caregiving experience, influenced ethical attitudes toward medical treatment decisions.

CONCLUSIONS

In relatively low-conflict situations, such as the announcement of a patient's medical condition, physicians tended to be patient-centered, while they tended to be family-centered in situations of strong conflict in withholding life-sustaining treatment. The fact that personal factors influenced the family-centered response in situations of strong conflict highlights the importance of not only acquiring knowledge of medical ethics but also learning to fairly apply this knowledge in practice.