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Survey on the experience in ethical decision-making and attitude of Pleven University Hospital physicians towards ethics consultation

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Abstract

Background

Contemporary medical practice is complicated by many dilemmas requiring ethical sensitivity and moral reasoning.

Objective

To investigate physicians’ experience in ethical decision-making and their attitude towards ethics consultation.

Methods

In a cross-sectional survey 126 physicians representing the main clinics of Pleven University hospital were investigated by a self-administered questionnaire. The following variables were measured: occurrence, nature and ways of resolving ethical problems; physicians’ attitudes towards ethics consultation; physicians’ opinions on qualities and skills of an ethics consultant, and socio-demographic characteristics. Data analysis included descriptive statistics, χ2 and t-test.

Results

Response rate was 88.9% (n = 112). Men and women were equally represented (48.2%–51.8%). The sample consisted of experienced physicians: 42.9% had 11–20 years experience, and 33% had 21–30 years. According to 84.8% of respondents, ethical problems have been discussed in their specialty. Predominant dilemmas included relationships with patients and relatives (76.8%) and team work (67.6%). Over ¾ of physicians needed an advice in solving ethical problems. Ninety six percent responded positively to ethics consultation. They would mainly request it for resolving conflicts (72.5%), and in case of concern for the rightness of their decisions (52.7%). The image of an ethics consultant was built of clinical competence (70.9%), ability to deal with conflicts (59.1%), communication skills (58.2%), tolerance for different views (55.4%), and a special qualification in ethics (52.7%).

Conclusions

The study underlined that Pleven University hospital physicians face similar ethical dilemmas as their colleagues in other countries do. The expressed positive attitudes to ethics consultation should serve as a basis for further research and development of ethics consultation services.

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References

  • Agich G.J. (1995) Authority in Ethics Consultation. Journal of Law, Medicine and Ethics 23, 273–283

    Article  CAS  Google Scholar 

  • Ausilio M.P., R.M. Arnold, S.J. Youngner (2000) Health Care Ethics Consultation: Nature, Goals, and Competencies. A Position Paper Form The Society for Health and Human Values – Society for Bioethics Consultation Task Force on Standards for Bioethics Consultation. Annals of Internal Medicine 133, 59–69

    Google Scholar 

  • Beck, S., A. van de Loo and S. Reiter-Theil: 2008, ‹A “Little Bit Illegal”? Withholding and Withdrawing of Mechanical Ventilation in the Eyes of German Intensive Care Physicians’, Medicine, Health Care and Philosophy 11

  • Boitte P. (1998) The Role of the Clinical Ethicist in the Hospital. Medicine, Health Care and Philosophy 1, 65–70

    Article  CAS  Google Scholar 

  • DuVal G., B. Clarridge, G. Gensler, M. Danis: (2004) A National Survey of US Internists’ Experiences with Ethical Dilemmas and Ethics Consultation. Journal of General Internal Medicine 19, 251–258

    Article  PubMed  Google Scholar 

  • DuVal G., L. Sartorius, B. Clarridge, G. Gensler, M. Danis: (2001) What Triggers Requests for Ethics Consultations? Journal of Medical Ethics 27 (supplement I), 124–129

    Google Scholar 

  • Foerde, R., R. Pedersen and V. Akre: 2008, ‹Clinicians’ Evaluation of Clinical Ethics Consultation in Norway: A␣Qualitative Study’, Medicine, Health Care and Philosophy 11

  • Hoffman D., A. Tarzian, J.A. O’Neil: (2000) Are Ethics Committee Members Competent to Consult? A Journal of The American Society of Law, Medicine & Ethics, 28(1), 1073–1105

    Google Scholar 

  • La Puma J., D.L. Schiedermayer: (1991) Ethics Consultation: Skills, Roles, and Training. Annals of Internal Medicine 114, 155–160

    PubMed  CAS  Google Scholar 

  • Reiter-Theil S. (2000) Ethics Consultation on Demand: Concepts, Practical Experiences and a Case studies. Journal of Medical Ethics 26(3), 198–203

    Article  PubMed  CAS  Google Scholar 

  • Reiter-Theil S. (2001) The Freiburg Approach to Ethics Consultation: Process, Outcome and Competencies. Journal of Medical Ethics 27(supplement I), 121–123

    Google Scholar 

  • Reiter-Theil S. (2003) Balancing the Perspectives. The Patient’s Role in Clinical Ethics Consultation. Medicine, Health Care and Philosophy 6, 247–254

    Article  Google Scholar 

  • Slowther A., C. Bunch, B. Woolnough, T. Hope (2001) Clinical Ethics Support Service in the Uk: An Investigation of the Current Provision of Ethics Support to Health Professionals in the UK. Journal of Medical Ethics 27(supplement I), 12–18

    Google Scholar 

  • Spike J., J. Greenlaw (2000) Ethics Consultation: High Ideals or Unrealistic Expectations?, Editorial. Annals of Internal Medicine 133, 55–57

    PubMed  CAS  Google Scholar 

  • Steinkamp N., B. Gordijn (2001) The Two-layer Model of Clinical Ethics and a Training Program for the Malteser Hospital Association. HEC FORUM 13(3), 242–254

    Article  PubMed  CAS  Google Scholar 

  • Ten Have H.:2001, Theoretical Models and Approaches to Ethics, in: H. Ten Have, B. Gordijn (eds.), Bioethics in a European Perspective. Kluwer Academic Publishers: Dordrecht, The Netherlands pp. 52–54

    Google Scholar 

  • Yen B., Schneiderman L. (1999) Impact of Pediatric Ethics Consultations on Patients, Families, Social Workers, and Physicians. Journal of Perinatology 19(5), 373–378

    Article  PubMed  CAS  Google Scholar 

Download references

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Correspondence to Silviya Aleksandrova.

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Aleksandrova, S. Survey on the experience in ethical decision-making and attitude of Pleven University Hospital physicians towards ethics consultation. Med Health Care and Philos 11, 35–42 (2008). https://doi.org/10.1007/s11019-007-9100-4

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  • DOI: https://doi.org/10.1007/s11019-007-9100-4

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