Ethics and empathy: The relationship between moral reasoning, ethical sensitivity and empathy in medical students

High-quality clinical practice includes not only improving clinicians' expertise in scientific and technical aspects but also managing values, ethical sensitivity and skills for assessing and dealing with ethical conflicts. The reviewed literature suggests the presence of an "ethical erosion", according to which ethical competence and empathy decrease or do not progress during medical training. The aim of this study was to determine the relationship between ethics (moral reasoning and ethical sensitivity) and empathy in a group of medical students and to determine the relationship with other variables such as academic year and sex.

A cross-sectional observational study was conducted with 193 medical students from different academic years, who were administered a sociodemographic questionnaire, the Rest sociomoral dilemma test, clinical vignettes to measure ethical sensitivity (Problem Identification Test [PIT]) and a cognitive and emotional empathy test (test de empatía cognitiva y afectiva, TECA).

We found a direct and significant relationship between moral development, ethical sensitivity and greater empathy. We detected an increase in moral reasoning and ethical sensitivity among first and third-year students, with no increase between the third year and later academic years. There were no significant differences between these variables and sex.

This study found a correlation between moral reasoning, ethical sensitivity and empathy and a lack of progression of the first 2 variables in the last years of the medical degree.