Examining the effects of interprofessional problem-based clinical ethics: Findings from a mixed methods study.

Understanding how interprofessional education (IPE) works in learning clinical ethics via problem-based learning (PBL) and how different professions' perspectives influence each other in this setting may inform future IPE. Eighty-nine students participated in a clinical ethics PBL and were assigned into three study groups, i.e., medical, nursing, and interprofessional groups. This study applied an explanatory sequential mixed methods design. The quantitative phase involved observation of the learning process in PBL tutorial with checklists to code students' performance of learning behaviour, ethics discussion skills, learning content explored, and analysis through comparison of accumulative percentage of the coded performance between groups. Content analysis of post-PBL homework self-reflections from interprofessional group was conducted as the following explanatory qualitative phase. Quantitative results indicated that nursing students performed favourably on course engagement, caring, and communication while medical students performed positively on issue identification and the life science aspect. Interprofessional group showed the strength of the both professions and performed best through the learning process. Content analysis revealed that students in the interprofessional group achieved interprofessional learning from recognizing the differences between to appreciating learning from each other and to sense the need of future collaboration. With early exposure to IPE, undergraduate students may learn to balance their socialized viewpoints by seeing ethical dilemmas from each other's standpoint.

Comparisons of life images and end-of-life attitudes between the elderly in Taiwan and New Zealand.

Rapid advances in medical technology may in the near future make "natural" aging and old age diseases the main causes of human death in affluent societies (apart from accidents). When dealing with end of life issues, medical sociology will need to focus more on life and death in seniors. Understanding the attitudes of older persons toward life and death is important for both performing end-of-life medical care and in developing end-of-life policies. Descriptive bioethical analysis of attitudes in different cultures can aid a fuller understanding of the views inside each culture and the trajectories of conflict situations within each culture. In-depth interviews were conducted with 112 senior citizens in Taiwan and with 25 senior citizens in New Zealand. All interviews were transcribed verbatim; qualitative data analysis was used to examine people's views on life and death. Their images of life and end of life attitudes were compared. Analysis of the key concepts they mentioned revealed distinctive views in life attitudes between these two groups. However, in spite of differences in culture and traditions, most life and end-of-life attitudes among elderly people in the two groups were rather similar. According to these similarities, an interpretation of these values was made within a Confucian and Taoist framework that might be applicable to non-Eastern cultures as well.

Heroes of SARS: professional roles and ethics of health care workers.

OBJECTIVES: To examine the professional moral duty of health care workers (HCWs) in the outbreak of severe acute respiratory syndrome (SARS) in 2003. METHODS: Descriptive discussion of media reports, analysis of ethical principles and political decisions discussed in the outbreak, with particular emphasis on the events in mainland China and Taiwan. RESULTS: There were differences in the way that Taiwan and mainland China responded to the SARS epidemic, however, both employed techniques of hospital quarantine. After early policy mistakes in both countries HCWs were called heroes. The label 'hero' may not be appropriate for the average HCW when faced with the SARS epidemic, although a number of self-less acts can be found. The label was also politically convenient. CONCLUSIONS: A middle ground for reasonable expectations from HCW when treating diseases that have serious risk of infection should be expected. While all should act according to the ethic of beneficence not all persons should be expected to be martyrs for society.