전문직으로서의 의사 직업윤리: 사회적 직관주의 이론을 바탕으로 한 일개대학 의학전문대학원생과 부속병원 전공의 간 비교*

Abstract

This study was designed to determine whether or not there are differences between the moral intuitionsof medical students and those of residents in clinical fields. A total of 370 of 490 (75.5%) students(n=340) and residents (n=30) at one university in South Korea responded to a survey consisting of theMoral Foundations Questionnaire (MFQ30) and additional items on moral judgments concerning theduty to care during pandemic influenza. Both groups selected beneficence/non-maleficence (as opposedto autonomy or justice) as the primary ethical principle(s) in medical practice. The mean scores on a0~5 scale for the five moral foundations for the students were not significantly different from those ofthe residents (harm; 3.6 vs. 3.4, fairness; 3.5 vs. 3.3, loyalty; 3.1 vs. 3.0, authority; 2.9 vs. 2.8, sanctity; 3.1vs. 3.0, respectively). However, there was considerable variability in individual items forming the scalesfor the fairness foundation. Interestingly, when respondents chose justice first among ethical principles,they felt that physicians had a duty to treat patients with influenza, even if in doing so they placed themselvesor their families at risk (OR 2.27, 95% CI 1.23~4.18). Our data suggest that social intuitionismmay be useful for explaining differences in Korean physicians’ moral judgments and also that it may bean effective tool for feedback in medical ethics education.