A Survey Of Physicians Regarding Ethical Dilemmas In Clincial Practice

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Abstract

This study is a cross sectional self-administered mailed survey designed to address the type and frequency of ethical dilemmas faced by physicians, how they approach them, the types of ethical support they would find useful in addressing these ethical dilemmas, and their attitudes and practices in situations of scarce resources. The questionnaire was designed, piloted, translated and back translated. Following IRB approval, the study sample included 656 general practitioners and general internists from each of four European countries including England, Switzerland, Norway and Italy. In 2013 we plan to expand this survey to include a sample of physicians from Ethiopia to examine how ethical dilemmas related to bedside rationing from a developing country compare to those in developed, resource-rich countries that have already been surveyed. In addition, in 2013 we plan to survey a sample of surgeons practicing in the US. The results of the European survey have been analyzed and six peer reviewed journal articles have been published and two book chapters have been published. These publications report: 1. The ethical difficulties encountered in clinical Practice by European doctors. 2. Physicians access to ethics support services in the four european countries in the study. 3. The prevalence and determinants of physician bedside rationing in four European countries. 4. Physicians views on resource availability and equity in four European health care systems. 5. An examination of whether ethics consultants should help clinicians face scarcity in their Practices. In 2009 a symposium was funded by and held at the Brocher Foundation to discuss and analyze the study findings. In 2010 we began to prepare an edited volume to be published by Oxford University Press that will include a summary of the study findings regarding bedside rationing, analysis of these findings, and recommndations for fostering ethical bedside rationing.