Physicians' attitudes toward clinical ethics consultation: a research study from Turkey
To identify the reasons why physicians request or do not request ethics consultation and to determine the priority of ethical issues for those demanding consultation. Materials and methods: This survey was conducted using a self-administered questionnaire, and 270 clinicians (surgeons and internists) from 3 different medical school hospitals were included. The questionnaire consisted of Likert-type statements related to the reasons for requesting or not requesting ethics consultation and a ranking list of ethical dilemmas according to the physicians' priorities. Results: Of all clinicians, 40.4% were employed in surgical departments and 59.6% in internal medicine departments. Most of the physicians (90%) stated that they wanted to demand ethics consultations. The first reason surgeons gave for demanding consultation was a desire to receive help with judicial problems; among internists, the most common reason for demanding a consultation was to achieve a clear conscience (P > 0.05). "Withdrawal of life-support-system decision" was determined to be the main subject for which clinicians requested ethics consultations. Conclusion: The results of this study indicate that clinicians require ethics consultations; nevertheless, it is a fact that there is a limited number of requests and inadequate experience with applying. This situation may be caused by the lack of clinical ethics support services that deal with ethics consultation in Turkey.
Physicians' attitudes toward clinical ethics consultation: a research study from Turkey
To identify the reasons why physicians request or do not request ethics consultation and to determine the priority of ethical issues for those demanding consultation. Materials and methods: This survey was conducted using a self-administered questionnaire, and 270 clinicians (surgeons and internists) from 3 different medical school hospitals were included. The questionnaire consisted of Likert-type statements related to the reasons for requesting or not requesting ethics consultation and a ranking list of ethical dilemmas according to the physicians' priorities. Results: Of all clinicians, 40.4% were employed in surgical departments and 59.6% in internal medicine departments. Most of the physicians (90%) stated that they wanted to demand ethics consultations. The first reason surgeons gave for demanding consultation was a desire to receive help with judicial problems; among internists, the most common reason for demanding a consultation was to achieve a clear conscience (P > 0.05). "Withdrawal of life-support-system decision" was determined to be the main subject for which clinicians requested ethics consultations. Conclusion: The results of this study indicate that clinicians require ethics consultations; nevertheless, it is a fact that there is a limited number of requests and inadequate experience with applying. This situation may be caused by the lack of clinical ethics support services that deal with ethics consultation in Turkey.
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- Davies L, Hudson LD. Why don’t physicians use ethics consultation? J Clinical Ethics 1999; 10: 116-25.
- Reiter-Th eil S. Ethics consultation on demand: concepts, practical experiences and a case study. J Med Ethics 2000; 26: 198-203.
- Reiter-Th eil S. Th e Freiburg approach to ethics consultation: process, outcome and competencies. J Med Ethics 2001; 27:21- 23.
- Slowther A, Bunch C, Woolnough B, Hope T. Clinical ethics support services in the UK: an investigation of the current provision of ethics support to health professionals in the UK. J Med Ethics 2001; 27: 2-8.
- Slowther A, Bunch C, Woolnough B, Hope T. Clinical ethics support in the UK: a review of the current position and likely development. London: Nuffi eld Trust; 2001.
- DuVal G, Clarridge B, Gensler G, Danis M. A national survey of U.S. internists’ experiences with ethical dilemmas and ethics consultation. J Gen Intern Med 2004; 19: 251-258.
- Godkin MD, Faith K, Upshur REG, MacRae SK, Tracy CS, PEECE Group. Project Examining Eff ectiveness in Clinical Ethics (PEECE): phase 1-descriptive analysis of nine clinical ethics services. J Med Ethics 2005; 31: 505-512.
- Gacki-Smith J, Gordon E. Residents’ access to ethics consultations: knowledge, use, and perceptions. Academic Medicine 2005; 80: 168-175.
- Forde R, Vandvik IH. Clinical ethics, information, and communication: review of 31 cases from a clinical ethics committee. J Med Ethics 2006; 31: 73-77.
- Orlowski JP, Hein S, Christensen JA, Meinke R, Sincich T. Why doctors use or do not use ethics consultation? J Med Ethics 2006; 32: 499-503.
- Racine E, Hayes K. Th e need for a clinical ethics service and its goals in a community healthcare service centre: a survey. J Med Ethics 2006; 32: 564-566.
- Hurst SA, Perrier A, Pegoraro R, Reiter-Th eil S, Forde R, Slowther AM et al. Ethical diffi culties in clinical practice: experiences of European doctors. J Med Ethics 2007; 33: 51-57.
- Karlıkaya E. Expectations and attitudes concerning ethics consultation of physicians’ goals in a community and nurses working in clinics. PhD dissertation, İstanbul University, Institute of Health Sciences; 2007 (in Turkish).
- Chwang E, Landy D, Sharp R. Views regarding the training of ethics consultants: a survey of physicians caring for ICU patients. J Med Ethics 2007; 33: 320-324.
- Nagao N, Aulisio MP, Nukaga Y, Fujita M, Kosugi S, Youngner S et al. Clinical ethics consultation: examining how American and Japanese experts analyze an Alzheimer’s case. BMC Medical Ethics 2008; 9: 2 (doi: 10.1186/1472-6939-9-2).