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Journal of Korean Neurosurgical Society 1994;23(5): 580-588.
Views of Senior Medical Student on the Management of Congenitally Disabled Patients.
Kyu Chang Wang, Byung Kyu Cho
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
A doctor has to establish his or her own philosophy of medical practice for the management of congenitally disabled patients. To help the senior medical students to put their ideas on the management of such patients in shape, a question which asked them to describe their views on the medical, social, ethical aspects of the management was included in the examination for the 225 senior students of Seoul National University College of Medicine in 1992. The responses were summarized. The dismal prognosis of some malformations, considerable cases of abandonment by the misconception of parents and doctors, the conflict among the family members caused by the economic burden and social handicaps, the relative lack of support and the psychological and vacational discrimination by the society were among the prevalent problem. Of the 225 students, 131(58%) insisted that 'all' the congenitally disabled patients be provided with the best quality of treatment while 26(12%) argued against the idea. Fifteen students(7%) recommended to have a certain period of 'natural selection' and 14(6%) denied and warned against the doctor's role as a decision maker. Eleven students(5%) stated that the aggressive treatment should be confined to the patients who were selected by the medical criteria which supports the abandonment of poorly disabled patients. Three(1%) emphasized the 'prevention' as the ultimate goal. Twenty five(11%) showed reponses which lacked their own ideas or were inappropriate. Representative or unique statements are quoted. Though the ideas of students were not so contradictory to one another, the views were diverse as much as the variety of problem in the management of congenitally disabled patients. The authors believe it is worthwhile to ask medical students to think about the medically and ethically difficult situations before he or she becomes a doctor.
Key Words: Congenitally disabled; Medical student; Selection
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