Decision-making in the face of bioethical conflict and training in Dentistry

Abstract This study aims to understand the relationship between conceptions of ethics and decision making in situations of bioethical conflict in practices of first-year dentistry students. Holistic case study with a qualitative approach was carried out, in two steps: in the first, 62 participants answered an online form with two questions about conceptions of ethics; in the second, 59 deliberated on two health situations with bioethical conflict. Discursive textual analysis was performed. Results show that students understand ethics as individual guidance in social and profession conduct. In training, students’ restricted conceptions of ethics are amplified in the decision-making exercises in the face of bioethical conflicts. The role of singular contexts is an element for the decision-making in learning that includes respect for life and not just the treatment of disease. The topic of bioethics, thus transversalized in the formative process, values people-centered care.摘要 本研究旨在探究牙科专业一年级学生在临床实践中遭遇生物伦理冲突（bioethical conflict）情境时，其伦理观念与决策行为之间的关联。本研究采用分两阶段实施的整体质性案例研究：第一阶段，62名参与者填写包含两道伦理观念相关问题的在线问卷；第二阶段，59名参与者就两起涉及生物伦理冲突的医疗情境展开研讨。本研究采用话语文本分析法开展数据分析。结果显示，学生将伦理视为社会行为与职业操守中的个体行为指引。在实训过程中，当遭遇生物伦理冲突情境时，学生本就局限的伦理观念会在决策练习中被进一步凸显。特定情境的作用是学习阶段决策考量的重要维度，该维度强调对生命的尊重，而非仅聚焦于疾病治疗。因此，在人才培养全过程中贯穿生物伦理学（bioethics）主题，有助于彰显以患者为中心的诊疗理念。