우리나라 의료윤리교육의 현황과 발전방향 : 누가 무엇을 어떻게 가르치고 평가할 것인가?

Abstract

This study examines the current status of ethics education in medical schools in Korea and addresses the following questions: "Who teaches medical ethics?" "What is taught?" and "How is it taught?" The study also surveys opinions on the questions of "Who should teach medical ethics?" "What should be taught?" and "How should it be taught?" From March to May 2006, a questionnaire was developed and sent to educators of medical ethics in Korea. Out of the 41 medical schools that received the questionnaire, 37 (90.2%) replied. Thirty six medical schools provide ethics education as part of their regular curricula; 28 schools (75.7%) offer independent courses in medical ethics, while 6 schools provide integrated/special lectures in medical schools. Thirty three medical schools (80.5%) reported teaching ethics in only one year of their curriculum, while the remaining 8 medical schools reported teaching ethics in 2 or more years. Two medical schools provided ethics courses in 5 years. Most schools offer ethics courses in the second or third year of medical schools, and 8 schools (21.6%) provide instruction in ethics in two or more medical courses. With respect to the question of who teaches, in 25 schools (67.6%) only one professor teaches medical ethics, while in the remaining 12 schools there are two or more instructors. Thirty schools do not have a full-time faculty member for medical ethics education. With respect to the question of what is taught, the most common content areas are 'ethical concepts,' 'the ethics of death and dying,' 'reproductive ethics,' and 'doctor-patient relationships.' As for the question of how it is taught, the most common methods are lectures (34 schools, 91.9%), group discussions (24 schools, 64.9%), and case studies. The majority of respondents indicated that current medical ethics education in Korea fails to meet the goals and standards of ethics education. The principal causes of this, according to respondents, are as follows: 1) an insufficient allocation of time for ethics education; 2) the lack of qualified instructors; and 3) the lack of recognition and support for the importance of ethics education in medical schools. As for the question of who should teach medical ethics, most of the educators believe that a team consisting of ethicists, clinicians, medical humanists, lawyers, and specialists is most suitable. Respondents ranked the following as the most important content areas: 1) 'ethical concepts'; 2) 'doctor-patient relationships'; 3) 'human rights and doctors.' The ranking reveals a continuing stress on the conceptual and theoretical bases for medical ethics. Concerning teaching methods, most respondents replied that the best method is small group discussion, although it is impractical due to the lack of teaching faculty. At a workshop where these results were discussed, educators of medical ethics expressed a need, given the lack of resources and professional personnel in Korea, to build a network to share resources and information for the betterment of ethics education in Korea.