Medicine, Health Care and Philosophy

, Volume 11, Issue 1, pp 35–42 | Cite as

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

Scientific Contribution

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.

Keywords

cross-sectional survey ethical decision-making ethical problems ethics consultant ethics consultation physicians’ attitudes university hospital 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Agich G.J. (1995) Authority in Ethics Consultation. Journal of Law, Medicine and Ethics 23, 273–283CrossRefGoogle Scholar
  2. 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, 59–69Google Scholar
  3. 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 11Google Scholar
  4. Boitte P. (1998) The Role of the Clinical Ethicist in the Hospital. Medicine, Health Care and Philosophy 1, 65–70CrossRefGoogle Scholar
  5. 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, 251–258PubMedCrossRefGoogle Scholar
  6. DuVal G., L. Sartorius, B. Clarridge, G. Gensler, M. Danis: (2001) What Triggers Requests for Ethics Consultations? Journal of Medical Ethics 27 (supplement I), 124–129Google Scholar
  7. Foerde, R., R. Pedersen and V. Akre: 2008, ‹Clinicians’ Evaluation of Clinical Ethics Consultation in Norway: A␣Qualitative Study’, Medicine, Health Care and Philosophy 11Google Scholar
  8. 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), 1073–1105Google Scholar
  9. La Puma J., D.L. Schiedermayer: (1991) Ethics Consultation: Skills, Roles, and Training. Annals of Internal Medicine 114, 155–160PubMedGoogle Scholar
  10. Reiter-Theil S. (2000) Ethics Consultation on Demand: Concepts, Practical Experiences and a Case studies. Journal of Medical Ethics 26(3), 198–203PubMedCrossRefGoogle Scholar
  11. Reiter-Theil S. (2001) The Freiburg Approach to Ethics Consultation: Process, Outcome and Competencies. Journal of Medical Ethics 27(supplement I), 121–123Google Scholar
  12. Reiter-Theil S. (2003) Balancing the Perspectives. The Patient’s Role in Clinical Ethics Consultation. Medicine, Health Care and Philosophy 6, 247–254CrossRefGoogle Scholar
  13. 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), 12–18Google Scholar
  14. Spike J., J. Greenlaw (2000) Ethics Consultation: High Ideals or Unrealistic Expectations?, Editorial. Annals of Internal Medicine 133, 55–57PubMedGoogle Scholar
  15. 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), 242–254PubMedCrossRefGoogle Scholar
  16. 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. 52–54Google Scholar
  17. Yen B., Schneiderman L. (1999) Impact of Pediatric Ethics Consultations on Patients, Families, Social Workers, and Physicians. Journal of Perinatology 19(5), 373–378PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  1. 1.Department of Social and Preventive Medicine, Faculty of Public HealthUniversity of MedicinePlevenBulgaria

Personalised recommendations