Between professional values, social regulations and patient preferences: medical doctors' perceptions of ethical dilemmas

J Med Ethics. 2018 Apr;44(4):239-243. doi: 10.1136/medethics-2017-104408. Epub 2017 Nov 18.

Abstract

Background: We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice.

Methods: The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so. Conceptually, dilemmas arise because of tensions between two or more of four doctor roles: the patient's advocate, a steward of societal interests, a member of a profession and a private individual.

Results: 27 of the potential dilemmas were considered dilemmas by at least 50% of the respondents. For more than half of the dilemmas, the anticipated course of action varied substantially within the professional group, with at least 20% choosing a different course than their colleagues, indicating low consensus in the profession.

Conclusions: Doctors experience a large range of ethical dilemmas, of which many have been given little attention by academic medical ethics. The less-discussed dilemmas are characterised by a low degree of consensus in the profession about how to handle them. There is a need for medical ethicists, medical education, postgraduate courses and clinical ethics support to address common dilemmas in clinical practice. Viewing dilemmas as role conflicts can be a fruitful approach to these discussions.

Keywords: clinical ethics.

MeSH terms

  • Attitude of Health Personnel*
  • Conflict, Psychological
  • Ethics*
  • Ethics, Clinical
  • Health Care Surveys
  • Humans
  • Morals
  • Norway
  • Patient Preference / statistics & numerical data*
  • Patient Rights / ethics*
  • Physicians / ethics*
  • Physicians / psychology
  • Professional Autonomy
  • Professional-Family Relations / ethics*
  • Social Responsibility
  • Social Values
  • Surveys and Questionnaires