Meanings about bioethics that emerge in patients who had participated in medical training processes. Medellin, Colombia. 2017

Authors

DOI:

https://doi.org/10.17533/udea.iatreia.27

Keywords:

bioethics, clinical clerkship, medical, education, patient rights, professional training, students

Abstract

Objective: To understand the meanings about bioethics that emerge among patients treated in academic practices, in undergraduate and postgraduate medical training processes in Medellín, 2017.

Materials and methods: With a hermeneutic approach based on the constructivist paradigm, 17 semistructured interviews were conducted in adults. The analysis was carried out with the use of grounded theory techniques.

Results: As a central meaning, the instrumentalization of the patient emerged in the learning process of the students, in which the formative interest over the patient’s care prevails. Other meanings that emerged are: hierarchical subordination in clinical and academic relationships, limitation of recognition of rights and duties of patients, as well as diversity in satisfaction with care. There was discomfort when the patient felt ignored in the teaching communication - students. The contribution of the patient to learning is highlighted.

Discussion and conclusion: There is a favorable disposition of the patients to participate in the medical training in non-invasive processes, with limitation of the number of students and with a teacher who is aware of the patient. Medical training should give the patient an active role in academic practices, recognize their needs for dialogue, confidentiality, privacy, respect for their autonomy and dignity, promoting relationships between patients, students and teachers based on bioethical values and principles.

|Abstract
= 376 veces | PDF (ESPAÑOL (ESPAÑA))
= 191 veces| | HTML (ESPAÑOL (ESPAÑA))
= 17 veces|

Downloads

Download data is not yet available.

Author Biographies

Elsa María Villegas-Múnera, University of Antioquia

Full professor, Faculty of Medicine. Doctor in Bioethics.

Martha Lucía Escobar-Pérez, University of Antioquia

Full professor, Faculty of Medicine. Collective Health Master.

Carlos Enrique Yepes-Delgado, University of Antioquia

Full professor, Faculty of Medicine. Doctor in Epidemiology.

David Arnovis Hernández-Carmona, University of Antioquia

Occasional teacher National School of Public Health. Collective Health Master.

References

(1.) Lavados Montes C, Lolas Stepke F, Drumond de Frías JG. Bioética. Acta bioeth. 2013;19(1):157-61. DOI 10.4067/S1726-569X2013000100020.

(2.) Collado J. La bioética como ciencia transdisciplinar de la complejidad: una introducción coevolutiva desde la gran historia. Rev Colomb Bioet. 2016;11(1):54-67.

(3.) Emanuel EJ, Emanuel L. Cuatro modelos de la relación médico paciente. Madrid: Bioética para clínicos; 1999.

(4.) Beca JP, Browne F, Valdebenito C, Bataszew A, Martínez MJ. Student patient relationship from the patient’s point of view. Rev Med Chil. 2006;134(8):955-9. DOI /S0034-98872006000800002.

(5.) Sánchez MA. El humanismo y la enseñanza de las humanidades médicas. Educ Med. 2017;18(3):212-8. DOI 10.1016/j.edumed.2017.03.001.

(6.) Molina Montoya NP. Formación bioética en ciencias de la salud. Cienc Tecnol Salud Vis Ocul. 2016;14(1):117-32. DOI 10.19052/sv.3544.

(7.) Arcila PA, Mendoza YL, Jaramillo JM, Cañón OE. Comprensión del significado desde Vygotsky, Bruner y Gergen. Diversitas; 2010;6(1):37-49.

(8.) Lincoln YS, Lynham SA, Guba EG. Paradigmatic controversies, contradictions and emerging confluences, revisited. Los Angeles: Sage; 2011.

(9.) Corbin J, Strauss A. Francis K. Basics of qualitative research techniques and procedures for developing grounded theory. California: Sage Publication; 2006.

(10.) Blumer H. The Metodological Position of Symbolic Interactionism. Vilnius University Press. 1969;2(2).

(11.) Yeasmin S, Rahman KF. “Triangulation” research method as the tool of social science research. BUP Journal. 2012;1(1):154-63. 12. Engward H, Davis G. Being reflexive in qualitative grounded theory: Discussion and application of a model of reflexivity. J Adv Nurs. 2015;71(7):1530–8. DOI 10.1111/jan.12653.

(13.) Kostov C, Rees C, Gormley G, Monrouxe L. ‘I did try and point out about his dignity’: a qualitative narrative study of patients and carers’ experiences and expectations of junior doctors. BMJ Open. 2018;8(1):e017738. DOI 10.1136/bmjopen-2017-017738.

(14.) Soberanes JL. Reflexiones sobre el concepto de dignidad humana y su proyección en el campo de la bioética. En: Gonzáles Valenzuela J, coordinador. Perspectivas de bioética. México: UNAM, Facultad de Filosofía y Letras; 2007. p. 237-324.

(15.) Hicks LK, Lin Y, Robertson DW, Robinson DL, Woodrow SI. Understanding the clinical dilemmas that shape medical students’ ethical development: questionnaire survey and focus group study. BMJ. 2001;322(7288Re):709-10.

(16.) Aquilina T, Thompson S, Metcalfe K, Hughes H, Sinclair L, Batt F. The involvement of older inpatients in medical student education. Eur Geriatr Med. 2018;9(1):77-82. DOI 10.1007/s41999-017-0023-1.

(17.) Feito L. Vulnerabilidad. An. Sist. Sanit. Navar. 2007;30(3):7-22.

(18.) Sánchez Gonzalez MA. La relación clínica. Paternalismo y autonomía. Objeción de consciencia. En: Bioética en Ciencias de la Salud. Barcelona; Masson 2012. p. 189-98.

(19.) Agrawal U, D’Souza BC, Seetharam AM. Awareness of Patients’ Rights among Inpatients of a Tertiary Care Teaching Hospital– A Cross-sectional Study. J Clin Diagn Res. 2017;11(9):IC01-IC06. DOI 10.7860/JCDR/2017/24961.10544.

(20.) Yaghobian M, Kaheni S, Danesh M, Rezayi Abhari F. Association between Awareness of Patient Rights and Patient’s Education, Seeing Bill, and Age: A Cross-Sectional Study. Glob J Health Sci. 2014;6(3):55-64. DOI 10.5539/gjhs.v6n3p55.

(21.) Silva Junior G, Duarte R, Menezes A, Morais A, Alves A, Daher E. Percepção dos pacientes sobre aulas práticas de medicina: uma outra ausculta. Rev Bras Educ Med. 2014;38(3):381-7.

(22.) Camps V. Los valores éticos de la profesión sanitaria. Educación Médica. 2015;16(1):3-8. DOI 10.1016/j.edumed.2015.04.001.

(23.) Ramalho A, Da Silva MR. Percepção dos pacientes sobre a sua participação como Instrumento de Aprendizado nas aulas práticas de Semiologia. ACM. 2006;35(3):35-41.

(24.) Sousa-Muñoz R, Ronconi D, Ramalho C, Andrade M, Silva A, Pereira G et al. Opinión de los pacientes sobre su participación en la enseñanza práctica de medicina en un hospital universitario de Brasil. Educ méd. 2011;14(1):35-7.

(25.) Hopkins J. Defining the Patient-Physician Relationship for the 21st Century. Dis Manag. 2004;7(3):161-79. DOI 10.1089/dis.2004.7.161.

(26.) Gracia D. Epilogo: el médico perfecto. En: Fundamentos de Bioética. Madrid: Triascastela; 2008.p. 597-602.

(27.) World Medical Association [Internet]. WMA - The World Medical Association-WMA Declaration of Geneva; 2008. [Accedido 26 Nov. 2018]. Disponible en: https://www.wma.net/policies-post/wma-declaration-of-geneva/

(28.) Kant M. Fundamentación de la metafísica de las costumbres [Internet]. Traducido por Manuel García Morente. San Juan, Puerto Rico: edición de Pedro M. Rosario Barbosa, 2007. [Acceso el 14 de noviembre de 2018] Disponible en: https://pmrb.net/books/kantfund/fund_metaf_costumbres_vD.pdf

(29.) Dearman S, Joiner A, Gordon M, Vince G. Experiences of Patients with Mental Illness’ Interactions with Medical Students: A Systematic Review. Can J Psychiatry. 2017;63(1):4-11. DOI 10.1177/0706743717730824.

(30.) Howe A, Anderson J. Involving patients in medical education. BMJ. 2003;327(7410):326-8. DOI 10.1136/bmj.327.7410.326.

(31.) Hottois G. El paradigma bioético. Una ética para la tecnociencia. Barcelona: Anthropos; 1991.

(32.) Unesco. Declaración universal de Bioética y Derechos Humanos [Internet]. UNESCO; 2005 [Consultado 2018 nov 14] Disponible en: https://bit.ly/19wMRYn

(33.) León Correa FJ. Enseñar Bioética: cómo transmitir conocimientos, actitudes y valores. Acta Bioéthica. 2008,14(1):11-18. DOI 10.4067/S1726-569X2008000100002.

Published

2019-10-01

How to Cite

1.
Villegas-Múnera EM, Escobar-Pérez ML, Yepes-Delgado CE, Hernández-Carmona DA. Meanings about bioethics that emerge in patients who had participated in medical training processes. Medellin, Colombia. 2017. Iatreia [Internet]. 2019 Oct. 1 [cited 2025 Jan. 30];32(4):276-87. Available from: https://revistas.udea.edu.co/index.php/iatreia/article/view/335305

Issue

Section

Original research

Most read articles by the same author(s)