Medical Ethics Education in the Training Process of Medical Staff

In other words, medical ethics are standards and principles recognized by society and the professional conscience of a physician.

+ Medical ethics are written regulations of a legal nature that both doctors and patients must follow.

It can be seen that medical ethics are standards and rules in social life set out to regulate the behavior and relationships of physicians related to their profession. It is a measure of the conscience, responsibility, and duty of a physician. Medical ethics of health workers is a part of social ethics.

According to author Do Nguyen Phuong, " Medical ethics are the standards and rules of social life, regulating the behavior and relationships of doctors with patients as well as with colleagues. It determines the duties, conscience, honor and happiness of doctors " [34]

In short, medical ethics is the ethics of medical practitioners, a system of professional conduct rules specific to the medical profession, expressed through ethical standards and principles recognized by society, to regulate the behavior and conduct of physicians towards patients and the community. Medical ethics determines the responsibility, conscience, honor and happiness of physicians. Medical ethics, also known as medical ethics, is the conduct or behavior of physicians when interacting with patients, treating them, caring for them and through them taking care of the health of their families and the community in which they live.

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1.2.4. Concept of medical ethics education

From the basic concepts mentioned above, it can be understood that medical ethics education is a purposeful, planned, and methodical process of impact by educators to help medical students self-discipline, actively self-educate, self-cultivate, and practice to meet the ethical standards of the medical profession, forming good qualities of future doctors.

1.2.5. Concept of managing medical ethics education activities

From the concept of management and QLGD, we can understand that managing medical ethics education activities is the conscious impact of the management subject on the management object to bring medical ethics education activities to achieve the best results.

Managing medical ethics education activities must aim to make all educational forces correctly aware of the importance of medical ethics education activities, actively participate in the process of medical ethics education. Managing medical ethics education activities is managing both the goals, content, forms and methods of medical ethics education, synchronously mobilizing educational forces inside and outside the school to effectively carry out the task of medical ethics education, and promote the self-education capacity of students. Managing medical ethics education activities is the process of oriented impact of the management subject on the elements participating in medical ethics education activities to effectively implement the goals of medical ethics education.

1.3. Medical ethics education in the training of medical staff

1.3.1. Goals and tasks of training medical staff

1.3.1.1. Objectives of training medical staff

- General objectives

Training a team of medical staff with professional qualifications, good practical skills, good political qualities, dedication, serving patients and constantly studying to improve professional qualifications.

Develop a medical examination and treatment workforce that is sufficient in quantity, strong in quality, and reasonably structured, in the direction of optimizing distribution between regions and between specialties, meeting the needs of health care, especially early care, based on the community, in parallel with technical development to contribute to improving the quality of medical examination and treatment services, realizing the goals of fairness, efficiency and development.

- Specific goals

Rapidly increase the number of human resources, especially doctors, through various types of training, prioritizing human resources for disadvantaged localities, district hospitals and commune health stations;

Special attention is paid to developing a team of specialist doctors to meet the needs of technical development and hospital upgrading, in order to improve the quality of medical examination and treatment;

Improve the qualifications and capacity of human resource management for hospital management staff;

Develop policies and reasonable remuneration for medical examination and treatment personnel, especially in mountainous, island, and disadvantaged areas, areas with many ethnic minorities, and some less attractive specialized fields to balance the distribution of medical examination and treatment personnel, contributing to improving the quality of medical examination and treatment at lower levels.

1.3.1.2. Tasks of training medical staff

- Determine needs, develop training plans and programs for approval by the Principal and organize and coordinate training activities, continuous training, professional knowledge improvement, and technology transfer for medical staff according to the Ministry of Health's targets and social needs.

- Organize and coordinate training activities:

Continuous training for medical staff working in the medical field in Vietnam to update knowledge, skills, and attitudes in the field of medical expertise to contribute to the implementation of Circular 07/2008/TT-BYT of the Ministry of Health on "Guidelines for continuous training for medical staff".

- Training level I specialists and level II specialists for medical staff in public medical facilities, non-public medical facilities, and medical staff who want to change their major due to the needs of the recruiting agency or individuals.

- Specialized foreign language training: Training and granting specialized foreign language certificates to medical staff who want to improve their foreign language proficiency for self-training, research, to participate in short-term and long-term working groups abroad, to participate in short-term training programs or to obtain degrees.

- Carry out technology and technical transfers to improve skills for medical staff and learners with legitimate needs.

- Cooperate with other organizations and units to participate in training in accordance with the provisions of law.

1.3.2. Psychological and sociological basis of the medical profession

1.3.2.1. Psychological basis of the medical profession

Psychological characteristics of the doctor's service audience

- Illness affects psychology and vice versa, illness is affected by the psychology of the patient. Any illness, whether severe or mild, affects the patient's spirit. Illness affects relatives and those around them, causing anxiety and changes in the economy, daily life and family happiness.

- Illness changes the patient's psychology, sometimes only slightly changing emotions, but sometimes strongly and deeply changing the patient's entire personality. Usually, the more severe and longer the illness lasts, the more serious the psychological changes.

- Illness can change a patient from a calm, self-controlled, modest person to an irritable, difficult, and hot-tempered person; from a thoughtful person who likes to care for others to a selfish person; from a cheerful and lively person to a pensive, lethargic person; from a polite and gentle person to a strict and harsh person who criticizes others; from an independent person to a superstitious person who believes in fortune telling... However, sometimes illness can change the patient's psychology in a way that makes them love and care for each other more. It can make the patient have a higher determination...

- Each person has a different attitude towards illness. Some people think that illness is an unavoidable misfortune and have to accept it. Some people are determined to fight against illness; others are afraid and worried about illness; sometimes we meet sick people who enjoy their illness. Besides those who pretend to be sick, there are those who pretend not to be sick.

- Common symptoms in patients

+ Fear

+ Anxiety, agitation

+ Depression

+ Angry

+ Selfish

+ Retreat

1.3.2.2. Sociological basis of the medical profession

- Characteristics of the medical profession

Medicine is a special profession, because no other profession enters human life as deeply and urgently as medicine. It has a practical relationship with human life and health, with the happiness of each family, the future of the race, with the health and prosperity of a nation and of the whole society.

- The position of the doctor and the patient

The object of service of the doctor is the patient, it is not a machine, a building or a road but a "person" a specific person who is in a state of illness, suffering both physically and mentally, they need the attention, need to be cured and helped by the doctor. Their health and life are entrusted to the doctor, so carelessness, indifference and formalism in the doctor cannot be forgiven.

1.3.3. Content of medical ethics education during training

- The content of medical ethics education first of all needs to help students understand more clearly and deeply the role and importance of medical ethics in their studies and throughout their future careers.

- Medical ethics education needs to analyze for students to better understand the prominent medical ethics viewpoints from the past to the present:

For example, the famous physician Tue Tinh (14th century) gave this advice:

“The Southern Heaven is a brocade land, the Red River flows long, the Garden of happiness and righteousness, the spring wind blows widely, pitying the people who are dying.

Choose the wisest way” [8]

Hai Thuong Lan Ong Le Huu Trac (18th century) gave up his ambition to become famous to devote his whole life to the profession of medicine to cure and save people. During his 40 years of practice, he left behind a great legacy of traditional medicine and profound lessons about the ethics of medicine for doctors. Until now, those lessons of Hai Thuong Lan Ong still have their value: "The ethics of medicine is a humane art that specializes in protecting human life, must worry about people's worries and be happy about people's happiness, only take saving people's lives as one's duty, should not seek profit or boast about achievements, although there is no immediate reward, but it leaves behind gratitude later". [8]

In modern times, right from the early years of building the country, in his position as the highest leader, President Ho Chi Minh paid special attention to the development of the country's healthcare, especially in the issue of medical ethics. Ho Chi Minh's view on medical ethics originated from the noble humanistic ideology and carried the nature of revolutionary ethics, expressed first of all in the profound love for humanity and people that he generalized into a philosophy of life: after all, all problems... are to be human, to love the country, to love the people, to love the suffering and oppressed humanity. That is the sympathy with the workers who suffered injustice in the old society. Human in Ho Chi Minh's thought does not only mean "compatriots" in the country, but also all of humanity.

Inheriting the nation's medical ethics tradition and the ethical values of world medicine, Ho Chi Minh put forward specific views on the medical ethics of Vietnamese physicians, which are considered by the medical sector as the guiding principle for the development of the country's healthcare. Ho Chi Minh's thoughts on medical ethics include two basic contents:

First: A doctor must have conscience and responsibility towards the patient.

Second: Doctors must build solidarity with colleagues.

Medical ethics education needs to show students clearly the ethical standards of medical workers: (Issued with Decision No. 2088/BYT-QD dated November 6, 1996 of the Minister of Health). [6]

Medical ethics is a good quality of a medical worker, expressed in a high sense of responsibility, dedicated service, wholehearted love and care for patients, considering their pain as their own, as President Ho Chi Minh taught: "A good doctor must be like a mother". We must be honest, united, overcome difficulties, study and strive to fulfill our duties, wholeheartedly build Vietnamese medicine. Medical ethics must be demonstrated through ethical standards and principles recognized by society.

1- Taking care of people's health is a noble profession. When volunteering to join the medical profession, one must seriously follow Uncle Ho's teachings. One must have a high sense of conscience and responsibility, wholeheartedly love the profession, and always practice to improve the ethical qualities of a physician. Continuously study and actively conduct scientific research to improve professional qualifications. Be ready to overcome all difficulties and hardships for the cause of caring for and protecting people's health.

2- Respect the law and strictly follow professional regulations. Do not use patients as experimental subjects for diagnostic, treatment, or scientific research methods without permission from the Ministry of Health and the patient's consent.

3- Respect the people's right to medical examination and treatment. Respect the patient's privacy; when examining and caring for them, ensure confidentiality and courtesy. Pay attention to patients who are eligible for social preferential policies. Do not discriminate against patients. Do not have an attitude of favoritism, abuse of the profession and cause trouble for patients. Be honest when paying for medical examination and treatment costs.

4- When interacting with patients and their families, always be friendly and enthusiastic; dress neatly and cleanly to create trust in the patient. Explain the patient's illness to the patient and their family so they can cooperate in treatment; inform them about the patient's regime, policies, rights and obligations; encourage and motivate the patient to receive treatment and exercise to recover quickly. In case of serious illness or poor prognosis, you must also wholeheartedly treat and care for the patient to the end, and at the same time inform the patient's family.

5- In emergency, urgent diagnosis and timely treatment are required and the patient must not be rushed.

6- Prescriptions must be consistent with the diagnosis and ensure the rational and safe use of drugs; do not, for personal gain, give patients poor quality drugs or drugs that do not match the requirements and severity of the disease.

7- Do not leave your position while on duty, monitor and promptly handle patient developments.

8- When the patient is discharged from the hospital, they must be carefully instructed to continue treatment, take care of themselves and maintain their health.

9- When a patient dies, we must deeply sympathize, express condolences and guide and help their family to complete the necessary procedures.

10- Honest, united, respectful of colleagues, respectful of teachers, willing to impart knowledge, learn from experience, and help each other.

11- When you have shortcomings, you must voluntarily take responsibility for yourself, not blame your colleagues or the front line.

12- Actively participate in health education and propaganda, disease prevention, and treatment of people with accidents and illnesses in the community; set an example in practicing a hygienic lifestyle and maintaining a clean environment.

In addition, the Ministry of Health also issued Decision No. 2526/1999/QD-BYT dated August 21, 1999 of the Minister of Health on promulgating the "Specific standards for striving for medical ethics", applicable to hospital staff and civil servants.

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