Tóm tắt Luận án Phát triển y đức của người thầy thuốc quân đội hiện nay (bản tiếng anh)

INTRODUCTION 1. An overview introduction of the thesis A true physician treats diseases to save patient not only for his/her responsibility, but also for his/her professional conscience, for his/her compassion for the patient. President Ho Chi Minh wrote in a letter to staffs of the health sector: "A physician must be as a gentle mother", which is to teach the physician to be moral (ethics) in his work. If the art of medicine makes fame, medical ethics creates the human dignity of the physician, all for the sake of human life. In today's society, to the rapid development of science, and technique, people’s physical and spiritual life is getting more and more improved, people’s increasing health care needs requires the physicians to have the professional capacity and good moral character. Due to the reverse side of the market economy, ethics of physicians now have signs of degradation, creating discontent in public opinion. Therefore, the study of developing the medical ethics of physicians in general and developing the medical ethics of military physicians in particularly has become imperative in both theory and practice. Developing ethical themes of the current military physicians systematizes ideas and ethical studies, clarifies the nature of medical ethics and the development of medial ethics of military physicians; indicates the current context and the factors affecting the development of medial ethics, operational characteristics of military physicians and the role of the development of medial ethics; gives the content of the development of medial ethics and the criteria to assess the development of medical ethics; builds measures to education, retraining and training the development of medial ethics to military physicians in order to meet the requirements of health care and health protection for the troops and the people in the process of building and protecting the country today. 2. Reasons for choosing thesis Morality is a social phenomenon which plays a particularly vital role in the life of humanity. Ethics is relevant to all members of society, to all areas of human activity, including health sector. Medical ethics is ethics of the medical profession - a noble quality of a physician, medical ethics is formed thanks to the education in schools and developed thanks to selftraining, and cultivation in practical activities of each physician. Ethics of physicians is always affected by the social and political factors in each period, and stage of social development , and the professional activities. Therefore, the study of the development of medical ethics of military physicians which owns particular characteristics in the current situation is an issue that needs to be studied further as a stand-alone topic that military medical practices are required . Since the Vietnam People's Army was founded until now, in wartime as well as peacetime, teams of military physicians are always present everywhere, at all times, even in the most dangerous places, in the most fierce point, to rescue, care for and protect the health of the troops to defeat the enemy. Military physicians also participate in scientific research contributing to the improvement of the country's medical quality and quality improvement activities at the military base, striving par with other medical facilities in the country and in the region. Currently, military physicians not only undertake health policy of Vietnam Communist Party, and VN Government but also participate in combined military operations - civilian medical and health care for the people, the work of epidemic prevention, disaster recovery and begin to engage in humanitarian activities, peace protection of the UN. During the journey of dedication and maturity, military physicians have the example of the will of fighting, the attitude of serving patients, demonstrating sublime qualities of military doctors - Uncle Ho's soldiers loved by the army and people. Central Resolution 9 course XI has identified, along with the socio-economic development of the country "The recession in terms of ideology, politics, ethics and lifestyle within the Vietnam Communist Party and in society tends to increase" [17, p.155]. Due to the impact from the downside of the market mechanism, of individualism, there has been led to the decline of morality and lifestyle of a section of officers and Vietnam Communist Party members, including medical staffs. Having a phenomenon of running after money, lack of sense of responsibility when serving the sick, and looking down on health and life of the patient have reduced the confidence in the army and the people. Some officials and medical staffs have misconceptions about ethical values, neglect of self-training and self care. If the negative expressions are slowly recovered, the confidence of the people for the good traditions of the health sector in general and military medicine in particular will be eroded. In terms of theory, there have been many research projects and ethical course of moral education for physicians in the country and the world. However, the problem of development of medical ethics of military physicians, particularly in terms of market economy, international integration has never been studied systematically by any authors. Finding answers to the issue of medical ethics development of military physicians in the new era is an objective requirement, which is urgent both theoretically and practically. For these reasons we selected the issue on the Development of medical ethics of military physicians to address my doctoral thesis. 3. Purpose and tasks of the research 3.1. Research purposes Study the rationale and survey of the ethical status of military physicians; propose measures of development of medical ethics of military physicians in the current situation. 3.2. Research Tasks - Study the rationale on medical ethics and the development of medical ethichs of military physicians. - Survey analysis and evaluate the development of medical ethics of doctors and the causes of the restriction. - Propose measures to develop medical ethics of military physicians today. - Conduct empirical measures of some measures to develop medical ethics of military physicians. 4. Object, subject and scope of research 4.1. Object of research The process of education, cultivation, and training the dignity of military physicians. 4.2. Subject of research The development of medical ethics military physicians in current period. 4.3. Scope of research - Content: The thesis studies on the rationale, practices and measures of human medical ethics development of military physicians. - The survey's objectivity: physicians working in hospitals, institutions, schools and military units; students studying in the military field;patients and patients' relatives. - Time: the survey data collected from 2009 to the present. 4.4. Hypothesis Development of medical ethics of military physicians now is dominated by objective factors and subjective conditions in the market mechanism, the development of modern medicine, as well as the characteristics of the medical profession in military. If we combine political and ideological education, medical ethics and medical law, military discipline and raise the level of expertise as well as participate in the fight of prevention of and against corruption in practice, medical ethics of military physicians will be developed. 5. Methodology and Methods of Research 5.1. Methodology - The research project is based on the view of dialectical materialism, thought of Ho Chi Minh, and the line of Vietnam Communist Party about revolutionary ethics and education of the development of medical ethics. - The research project was conducted on the access of system - structure, historical perspective – logical, developing perspective - activity, practical perspective to analyze, evaluate, and review related issues. 5.2. Methods of Research The thesis uses the combinations of the following methodologies: - The theoretical research methods - The practical research methods - The support methods 6. New contribution to the thesis - Reasoning: The thesis overviews ideas and work on medical ethics, build concepts to clarify the issues of ethical reasoning and medical ethics development of the physicians, launches the content and criteria to evaluate the development of medical ethics, points out the role as well as the factors affecting the development of the medical ethics of military physicians in current period. - In practice: clarify the current situation, characterize human activities of military physicians; practically evaluate the  development of medical ethics with objective data, point out the experience and trends of medical ethics development of military physicians, propose measures to develop medical ethics of military physicians today. 7. Theoretical and practical meaning of thesis - The reasoning: The thesis contributes additionally to the rationale on medical ethics and medical ethics development of physicians in general, and military physicians in particular. - On reality: The thesis provides document on the status of the medical ethics development of physicians, proposes measures to develop medical ethics of military physicians. The thesis can be used as a reference in research, teaching, training medical ethics and management for trainers, managers at the military medical units and hospitals in and outside the military . 8. Structure of the thesis The thesis includes: an introduction, an overview of research issues, four chapters (11 periods), conclusions and recommendations. In addition, there is a list of published works by authors, portfolio of references and appendices. OVERVIEW OF THE RESEARCH 1. Studies of medical ethics and medical ethics development abroad 1.1. Thoughts of medical ethics and medical ethics development in the world The moral issue of physician (medical ethics) was formed and developed very early in the history of world medicine. In civilization, historical period in the East or the West has made the teaching, medical and ethical basis, regulations, ethical standards for practitioners. Under development line of the history of medicine, medical ethics conceptions is gradually completed and there have been published works about the rules of ethics in the practice of medicine and human health. These are the basic ethical standards that physician must have during their professional activities. 1.2. The foreign research on medical ethics and the development of medical ethics Overseas, medical ethics issues, education, development of medical ethics of physicians have been studied under many different angles, as represented by the following works: The teaching of medical ethics , the premise of medicine by Pappworth M.H. (1978); The first issue of Healthcare by Butterworths Heinemann, Nigel C.H. Stott (1983); Ethics in medical practice by Verlag Berlin Heidelberg, Robet K. Mckinly, Pauline A. Mc Avoy (1996);Awareness of medical students on medical ethics education program by Johnston C. and Haughton P (2007). In their studies, the authors have mentioned the need to educate medical ethics in teaching, in clinical practice and health care. Also, the authors also point out the principles in practicing professional ethics of physicians. 2. Studies of ethics and medical ethics development in Vietnam 2.1. Thought of medical ethics and medical ethics development in Vietnam Ethics of physician Vietnam was formed and developed under the history of the medicine of the country. At first, it has the color of compassion, charity, morality influenced by oriental traditions, on the basis of Confucianism and Buddhism, creating distinctions in medical ethics in Vietnam. Typical thoughts about ethics in medicine of home countries are as: Pham Cong Ban (13th century) but came home to treat diseases for poor people. Chu Van An (1292 - 1370) was a physician, a teacher with virtue and talent. According to him, the crux of medicine profession is the humanirity. There must be humanarity then there will be intelligence, and intellectuals. Morality is the most important of the physician. Great physician Tue Tinh (Nguyen Ba Tinh, 1325-1399) has actual medical opinion and humanitarian. He advised the physician to do good, to help patients with a wide range, to bring the happiness for posterity. Hai Thuong Lan Ong Le Huu Trac (1720 - 1791) is the one who constructs the system of ethical standards for medical practice in Vietnam on the basis of inheriting the ethical ideology from Eastern culture to fit with Vietnam culture. Ethical issues was raised to new heights -revolutionary medical ethics by President Ho Chi Minh. According to him, ethics is not only a love for the patient, but also professional awareness, the cultivation to enhance the professional capabilities in order to better meet the demands of caring for and protecting the health of the army and the people. 2.2. The domestic research on medical ethics and the development of medical ethics In Vietnam, the issue of medical ethics and medical ethics education has also attracted the attention of many researchers and scientists. There have been many published works, including a number of works such as: Development of health work in our country in the current phase of Do Nguyen Phuong; Viewpoints on medical ethics of President Ho Chi Minh in Vietnam Health sector currently by Phan Viet Dung - Tran Van Thuy; State Administration by law in the health sector in our country today by Nguyen Huy Quang. In these works, the authors have clarified the views on the care and protection of people’s health , set ethical requirements for physicians in accordance with the thought of Ho Chi Minh, studied the works of formulation, promulgation and implementation of laws and the handling of violations of the laws of health. In the field of military medicine, There has also been a number of research projects such as: Improving the quality and effectiveness of the military medical guarantee by Nguyen Van Thang; Communication problems of military medical doctors with the patient during medical treatment by Nguyen Thi Thanh Ha; The solutions of combined medical ethics education through teaching specialized medicine subjects by Nguyen Quang Phuc; Improving the quality of VN communist party work and the work of politic contributes to fostering medical ethics in the military hospitals in the new situation by Nguyen Hong Giang; Research on solutions to improve the quality and capacity of medical staffs in the level of military detachments in the condition of the current economic market by Vu Dang Khien. The authors have stressed that military physicians have to dedicate in their work, communicate sensitively, and consider the health of patients as the health of their family members. In medical ethics education both professional competencies and personal qualities of physicians should be concurrently developed to enhance the political and ethical movement of military medical staffs, which meet the requirements of the current military operation. 3. General evaluation of research results of scientific works published and issues the thesis focuses on solving 3.1. General evaluation of the research results of scientific works published The above studies have mentioned aspects of medical ethics and medical ethics education, including the following outstanding results: - Having clarified the importance of ethics in health care for patients. The physician must know how to self-improve and professional ethics in medicine, to give treatment, to rescue people so as to fulfill his duties. - Having already mentioned the content of medical ethics of physicians. The authors suggest that genuine physicians have characteristic qualities, that is ideal, professional ethics, all for the patient's life. - Having proposed rules, ethical standards. Provide advice, guidance on ethics in the activity of medical and pharmaceuticals, in communicating with patients, in scientific research and clinical trials. However, the research also shows: - Not having clarified the ethos of medical ethics of ilitary physicians currently. - Not having clarified the influence of market mechanisms on medical ethics of military physicians , value orientation, the outlook on life of the physician, as well as measures to develop medical ethics in processes of medical practice. - Studies just stop at the general level for the target audience of doctors, medical students and medical practitioners and military medical officers, without referring to other subjects such as nurse, orderlies, nurses, pharmacists, assistant pharmacists. 3.2. Issues the thesis focuses on solving Based on the above analysis, the thesis focuses on the following issues: First, clarifying the peculiarities of medical ethics of military physicians. Military pysicians are both medical personnels, and soldiers. Their serving objects are war invalids, sick soldiers, the troops and the people. Their working place is often difficult, remote, mountainous areas, border and island. Medical condition is often in war field with insufficient medical equipment. Second, analyzing the expression of medical ethics so as to see the peculiarities of medial ethics of military physicians. Third, clarifying the process of education, medical ethics development. It is the process of education, training, ethics training for the physicians – soldiers. There should be processes, principles and specific methods, starting from the military medical school to activities in the health service. Fourth, clarifying the relationship between ethics, politics and law. Medical ethics of military physicians relates to the objects of service, to military tradition, social system and laws of the state. This is an issue that needs to be studied both in terms of theory and practice. Fifth, clarifying the development of medical ethics in scientific research and clinical trials. Medical ethics must now be conducted in scientific research, in clinical trials, corresponding to the development of modern medicine. These issues will be studied in a systematic way in the thesis: "Medical ethics development of military physicians currently." Chapter 1 RATIONALE OF MEDICAL ETHICS AND THE DEVELOPMENT OF MEDICAL ETHICS OF MILITARY PHYSICIANS 1.1. Theoretical issues of medical ethics 1.1.1. Morality Ethics is the propriety of the relationship between people, between individuals and groups of people and society. Ethics is the concept of happiness, conscience, honor, duty, responsibility, fairness, right ... These concepts revolve around the basic axis of good and evil and concretized a system of rules and standards in social relationships. Thanks to ethics that each regulates himself to suit the standards and the common benefits of society. 1.1.2. Professional ethics Professional ethics is ethics of workers in a particular field of activity, due to the characteristics of occupational regulations. Professional ethics is an important part of social ethics. There are many occupations in society, each job has its own characteristics, which have characterized the moral requirements. For those professions related to human life there are strict rules of ethics. Thus: Professional ethics are the moral standards in practice, reflect and respond to the specific nature of each profession, with the aim to bring maximum benefit to society, for human consumption. 1.1.3. Medical ethics 1.1.3.1. Working characteristics of physicians Working of the physician concerning to the lives of all peopla at all age, gender, wealth, poverty, social class since being a fetus until death. Therefore, the medical profession is considered a humane profession, physicians must master their profession, must have moral clarity, should be well and seriously trained. 1.1.3.2. The nature of medical ethics The ess