Keywords
clinical ethics
professional duty
moral judgement
medical professionalism
reflective practice
ethical decision-making
How to Cite
Abstract
Introduction. Competency-based medical education has shifted the focus of physicians' training from the accumulation of disciplinary knowledge to the formation of integrated abilities required for responsible clinical practice. In this context, deontological competence becomes important because it connects professional duty, ethical norms, patient-centred communication, clinical decision-making, and personal responsibility. However, current literature does not provide a unified understanding of its status within physicians' professional competence.
Aim. To summarise and critically analyse contemporary discussions on the essence, structure, and educational formation of physicians' deontological competence within the competency-based approach.
Materials and methods. This article is a narrative review based on qualitative and descriptive analysis of scholarly literature. The literature search was conducted in PubMed and Scopus. At the initial stage, approximately 300 sources were identified. After screening titles, abstracts, keywords, and full texts for relevance to the study aim, 18 publications were included in the final analysis. The selected sources were examined using conceptual analysis, comparative analysis, descriptive synthesis, and theoretical generalization.
Results. The review identifies three interrelated approaches. The cognitive-ethical approach interprets deontological competence through ethical knowledge, professional norms, and principles of decision-making. The integrative competency-based approach considers it as a component embedded in clinical competence and professionalism. The moral agency approach emphasises moral judgement, reflection, responsibility, and the physician's ability to act under ethical uncertainty. These approaches are complementary and correspond to cognitive, operational-behavioural, creative, motivational, and reflective components of deontological competence.
Conclusions. Deontological competence can be interpreted as an integrative component of physicians' professional competence with a pronounced normative and value-based orientation. Its formation requires not only teaching ethical rules but also reflective practice, clinical case analysis, feedback, and the integration of ethical reasoning into everyday professional training.
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