%0 Journal Article
%@ 2369-3762
%I JMIR Publications
%V 10
%N 
%P e52711
%T Challenges for Medical Students in Applying Ethical Principles to Allocate Life-Saving Medical Devices During the COVID-19 Pandemic: Content Analysis
%A Hsieh,Hsing-yen
%A Lin,Chyi-her
%A Huang,Ruyi
%A Lin,Guan-chun
%A Lin,Jhen-Yu
%A Aldana,Clydie
%+ School of Medicine for International Students, College of Medicine, I-Shou University, 8 Yida Rd, Yanchao District, Kaohsiung, 82445, Taiwan, 886 7 615 0011 ext 2547, ruyi@mail.harvard.edu
%K virtual patient
%K virtual patients
%K medical resources distribution
%K medical ethical education
%K COVID-19 pandemic
%K ethics
%K medical student
%K medical students
%K medical ethics
%K decision-making
%K ethical dilemna
%K simulation
%K reasoning
%K decision support
%K medical guideline
%K medical guidelines
%K medical devices
%K medical device
%K life-saving
%K thematic analysis
%K virtual platform
%D 2024
%7 5.1.2024
%9 Original Paper
%J JMIR Med Educ
%G English
%X Background: The emergence of the COVID-19 pandemic has posed a significant ethical dilemma in the allocation of scarce, life-saving medical equipment to critically ill patients. It remains uncertain whether medical students are equipped to navigate this complex ethical process. Objective: This study aimed to assess the ability and confidence of medical students to apply principles of medical ethics in allocating critical medical devices through the scenario of virtual patients. Methods: The study recruited third- and fourth-year medical students during clinical rotation. We facilitated interactions between medical students and virtual patients experiencing respiratory failure due to COVID-19 infection. We assessed the students’ ability to ethically allocate life-saving resources. Subsequently, we analyzed their written reports using thematic analysis to identify the ethical principles guiding their decision-making. Results: We enrolled a cohort of 67 out of 71 medical students with a mean age of 34 (SD 4.7) years, 60% (n=40) of whom were female students. The principle of justice was cited by 73% (n=49) of students while analyzing this scenario. A majority of them expressed hesitancy in determining which patient should receive life-saving resources, with 46% (n=31) citing the principle of nonmaleficence, 31% (n=21) advocating for a first-come-first-served approach, and 25% (n=17) emphasizing respect for patient autonomy as key influencers in their decisions. Notably, medical students exhibited a lack of confidence in making ethical decisions concerning the distribution of medical resources. A minority, comprising 12% (n=8), proposed the exploration of legal alternatives, while 4% (n=3) suggested medical guidelines and collective decision-making as potential substitutes for individual ethical choices to alleviate the stress associated with personal decision-making. Conclusions: This study highlights the importance of improving ethical reasoning under time constraints using virtual platforms. More than 70% of medical students identified justice as the predominant principle in allocating limited medical resources to critically ill patients. However, they exhibited a lack of confidence in making ethical determinations and leaned toward principles such as nonmaleficence, patient autonomy, adherence to legal and medical standards, and collective decision-making to mitigate the pressure associated with such decisions. 
%M 38050366
%R 10.2196/52711
%U https://mededu.jmir.org/2024/1/e52711
%U https://doi.org/10.2196/52711
%U http://www.ncbi.nlm.nih.gov/pubmed/38050366