Zalika Klemenc-Ketis1, Janko Kersnik, Janja Ojstersek. 1. Department of Family Medicine, Medical Faculty, University of Maribor, Kersnikova cesta 1, Velenje, Slovenia. zalika.klemenc-ketis@uni-mb.si
Abstract
AIM: To determine the prevalence of difficulties in managing ethical dilemmas in family practice. METHODS: The study included a random sample of 259 family medicine physicians, representing 30% of the population of family physicians in Slovenia. Participants were given a self-administered questionnaire on perceived ethical dilemmas in their practice, with responses on a 5-point scale and a maximum score of 100. The main outcome measure was the percentage of family physicians reporting difficulties in solving perceived ethical dilemmas. RESULTS: The response rate was 55%. Physicians reported having difficulties in solving ethical dilemmas often or very often (mean score+/-standard deviation, 56.1+/-12.1). The most difficult ethical issue included abandoned and unattended patients and patients with insufficient means of support (48.6%), followed by suspicion of physical abuse, sexual abuse, or other criminal behavior (40.9%), and use of limited health care resources (21.1%). Female physicians reported greater difficulties in solving ethical dilemmas than male physicians (57.7+/-10.6 vs 53.0+/-14.1, P=0.036, t test). Older physicians solved ethical issues more easily than younger ones (53.9+/-12.6 vs 58.2+/-11.2, P=0.043, t test). Specialists and residents in family medicine considered solving ethical dilemmas to be more difficult than general practitioners without specialization (57.3+/-11.6 vs 47.1+/-11.8, P=0.001, t test). Multivariate regression analysis of physician and practice characteristics did not yield any significant model to explain the differences in the perceived level of difficulties in solving ethical dilemmas. CONCLUSION: Although managing ethical dilemmas is an important part of daily work of family physicians in Slovenia, it is perceived as a considerable burden in their work. Family physicians need more training in addressing and managing ethical issues.
AIM: To determine the prevalence of difficulties in managing ethical dilemmas in family practice. METHODS: The study included a random sample of 259 family medicine physicians, representing 30% of the population of family physicians in Slovenia. Participants were given a self-administered questionnaire on perceived ethical dilemmas in their practice, with responses on a 5-point scale and a maximum score of 100. The main outcome measure was the percentage of family physicians reporting difficulties in solving perceived ethical dilemmas. RESULTS: The response rate was 55%. Physicians reported having difficulties in solving ethical dilemmas often or very often (mean score+/-standard deviation, 56.1+/-12.1). The most difficult ethical issue included abandoned and unattended patients and patients with insufficient means of support (48.6%), followed by suspicion of physical abuse, sexual abuse, or other criminal behavior (40.9%), and use of limited health care resources (21.1%). Female physicians reported greater difficulties in solving ethical dilemmas than male physicians (57.7+/-10.6 vs 53.0+/-14.1, P=0.036, t test). Older physicians solved ethical issues more easily than younger ones (53.9+/-12.6 vs 58.2+/-11.2, P=0.043, t test). Specialists and residents in family medicine considered solving ethical dilemmas to be more difficult than general practitioners without specialization (57.3+/-11.6 vs 47.1+/-11.8, P=0.001, t test). Multivariate regression analysis of physician and practice characteristics did not yield any significant model to explain the differences in the perceived level of difficulties in solving ethical dilemmas. CONCLUSION: Although managing ethical dilemmas is an important part of daily work of family physicians in Slovenia, it is perceived as a considerable burden in their work. Family physicians need more training in addressing and managing ethical issues.