Views on Bioethics Statements among Medical Students from Three Different Saudi Universities

Abstract

Objective To investigate the level of agreement with ethics statements amongst medical students from different Saudi Universities that use traditional or problem based learning (PBL) methods. Methods The respondents enrolled were medical students from Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) which utilizes PBL methods, King Saud University in Riyadh (KSU), and King Abdulaziz University in Jeddah (KAU), both of which utilize traditional methods. As all KSAU-HS medical students are applied medical science graduates, a fourth group consisting of applied medical science graduates from KSU and KAU were included as controls. The respondents were asked to grade their degree of agreement with 19 statements on different bioethical issues by using a Likert type scale from 1 to 5 (1= I completely disagree, 5= I completely agree). The 19 statements were further divided into 5 summative ethical domains: –(a) goals of medicine (3 questions), (b) autonomy and informed consent (9 questions), (c) quality of life (1 question), (d)resource allocation (4questions), and (e)withdrawal and withholding of treatment (2 questions). To avoid gender bias, only male students were sampled as KSAU-HS has only male students. Overall mean scores and mean scores for each statement and for each domain by each university were compared using unpaired two-tailed t test and Wilcoxon rank sum test. Results There were 43 students from KSAU-HS, 36 from KSU, 47 from KAU and 43 applied medical science graduates. There were significant differences between the overall mean scores by KSAU-HS on one hand (4.03 +/-0.69) and those by the other three groups on the other, being 3.75 +/- 0.66 (p=0.001) for KSU students, 3.76+/- 0.7 (p=0.015) for KAU students and 3,63 +/- 0.51 (p=0.0001) for the applied medical science graduates. The main differences between KSAU-HS students and the students from KSU and KAU were seen in the areas of objectives of medical care (p=0.05), autonomy (p=0.0001), patient centeredness (p=0.02), and informed consent (p=0.05). These differences could not be explained by the older age of KSAU-HS students or their being postgraduates as revealed by the different results seen with the applied medical science graduates. Conclusion The most paternalistic attitudes were held by the applied medical science graduates followed by KSU and KAU students. The least paternalistic were the students of KSAU-HS. We speculate that these differences are related to the different bioethics teaching and training methods used in the 3 universities.