Ethics education should make room for emotions: a qualitative study of medical ethics teaching in Indonesia and the Netherlands

Studies have shown that students may feel emotional discomfort when they are asked to
identify ethical problems which they have encountered during their training. Teachers
in medical ethics, however, more often focus on the cognitive and rational ethical
aspects and not much on students’ emotions. The purpose of this qualitative study was
to explore students’ feelings and emotions when dealing with ethical problems during
their clinical training and explore differences between two countries: Indonesia and the
Netherlands. We observed a total of eighteen ethics group discussions and interviewed
fifteen medical students at two medical schools. Data were interpreted and analyzed
using content analysis. We categorized students’ negative emotions based on their
objects of reflection and came up with three categories: emotions concerning their
own performance, emotions when witnessing unethical behaviors, and emotions related
to barriers and limitations of their working environment. Our study suggests that
addressing emotional responses in a culturally sensitive way is important to develop
students’ self-awareness. Teachers should be able to guide students to reflect on and be
critical of their own thoughts and emotions, to understand their own moral values,
especially when confronted with other individuals