Medical ethics: knowledge, attitude and practice among doctors in three teaching hospitals in Sri Lanka

Ranasinghe, A. W. I. P.; Fernando, Buddhika; Sumathipala, Athula; Gunathunga, Wasantha

doi:10.1186/s12910-020-00511-4

Cited by 29 publications

(48 citation statements)

References 17 publications

(21 reference statements)

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“…The importance of bioethics in medical programs is well acknowledged. 1–6 Ranasinghe et al 2 accentuate that comprehensive ethical training is necessary to prepare future health workers to anticipate and make decisions when faced with ethical dilemmas in daily practice. Woloschuk et al 7 observe that knowledge obtained during years of study impacts attitudes and in turn, attitudes guide behavior.…”

Section: Introductionmentioning

confidence: 99%

<p>Knowledge and Attitudes Towards Abortion and Euthanasia Among Health Students in Papua New Guinea</p>

Kolodziejczyk¹,

Kuzma²

2020

AMEP

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Purpose The purpose of this study was to explore knowledge and attitudes of health program students towards ethical issues pertaining to the beginning and the end of human life, and associations between these attitudes and demographic variables. Participants and Methods The study took a mixed-method approach with self-administered survey questionnaires and in-depth interviews. A total of 88 students participated in the survey, and 10 students participated in interviews. The study was conducted among students in the Health Extension Program at a Christian university in Papua New Guinea. Results Students showed a higher acceptance of abortion than euthanasia. More year-4 students presented significantly deeper knowledge of euthanasia and abortion compared to year-1 students. There were no gender differences regarding knowledge and attitude towards these two bioethical issues. The majority of students opposed the idea of women’s right to abortion, which is attributed mainly to socio-cultural reasons. The qualitative analysis indicated a very strong perception that having children ‘defines’ womanhood and also revealed general disapproval of any form of euthanasia. A low level of acceptance of various forms of euthanasia is associated with a respect for older people in Melanesian society and beliefs that ancestors’ support is required for achieving prosperity in life. Conclusion The study offered a comprehensive description and analysis of students’ knowledge and attitudes towards ethical issues pertaining to the beginning and the end of human life. Presented a low level of knowledge towards bioethical issues, together with a small proportion of the knowledge gained from lectures and tutorials, indicated inadequate teaching of bioethics and calls for further improvement. In the perspective of rapid social and cultural changes in the Papua New Guinea society, further studies on changing attitudes towards bioethics issues would be valuable.

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Section: Introductionmentioning

confidence: 99%

<p>Knowledge and Attitudes Towards Abortion and Euthanasia Among Health Students in Papua New Guinea</p>

Kolodziejczyk¹,

Kuzma²

2020

AMEP

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“…Many studies have drawn attention to significant deficiencies in understanding medical ethics among medical graduates [38,39]. Studies conducted in India [40], Nepal [41], and Srilanka [42] also revealed similar conclusions that most doctors' knowledge regarding clinical ethics was inadequate.…”

Section: Discussionmentioning

confidence: 94%

Does teaching medical ethics ensure good knowledge, attitude, and reported practice? An ethical vignette-based cross-sectional survey among doctors in a tertiary teaching hospital in Nepal

Shrestha

Joshi³

et al. 2021

BMC Med Ethics

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Background Importance of awareness of medical ethics and its integration into medical curriculum has been frequently highlighted. Study 1 aimed to assess the knowledge, attitude, and reported practices of medical ethics among clinicians at Patan Academy of Health Sciences, a tertiary care teaching hospital in Nepal. Study 2 was conducted to assess whether there was a difference in knowledge, attitude, and reported practices of medical ethics among doctors who received formal medical ethics education during undergraduate studies and those who did not. Methods Two cross-sectional surveys using self-administered questionnaires were conducted. Study 1 included 72 participants; interns, medical officers, and consultants working at Patan Academy of Health Sciences. Study 2 was a comparative study conducted among 54 medical officers who had received formal medical ethics education (Group 1) and 60 medical officers who did not (Group 2). Results Participants who had completed post-graduate education had higher knowledge (p = 0.050), practice (p < 0.001), and overall combined scores (p = 0.011). Participants with ethics education had higher knowledge (p < 0.001), attitude (p = 0.001), practice (p < 0.001), and overall score (p < 0.001). Most participants preferred consulting colleagues if an ethical dilemma arose. Fewer participants had heard of the Declaration of Helsinki. Most participants thought doctors to be most capable of judging what is best for the patient (Study 1: 70.42%, Study 2 Group 1: 42.59%, Group 2: 80%). Case scenarios in which participants demonstrated poor practice were ethical issues concerning truth-telling, end-of-life decisions, treating HIV/AIDS patients, treating a minor, and reporting colleague’s errors. Conclusions This study found that participants who have received medical ethics education have higher knowledge, attitude, and practice scores. The results further justify the need for medical ethics education to be a part of the core medical curriculum. A blame-free environment where seniors can be approached for advice should be created. Research ethics should also be given attention. During medical ethics training, ethical issues where doctors perform poorly should be given more priority and should be discussed in a country-specific context.

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“…However, this is common practice as a necessity in some contexts when the diagnosis is upsetting or taboo, for example during terminal illness [21]. There is currently a code of ethics for medical practitioners in Sri Lanka [32] which emphasizes honestly, but previous studies have shown there is lacking awareness of this document among doctors [27]. Some scientists have argued that in some contexts, a white lie is sometimes the best professional option to achieve a therapeutic goal [24] which may be the case in this instance where people are unwilling to seek treatment.…”

Section: Discussionmentioning

confidence: 99%

Antenatal depression in Sri Lanka: a qualitative study of public health midwives’ views and practices

et al. 2022

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Background Almost all pregnant people in Sri Lanka receive antenatal care by public health midwives. While there is strong infrastructure in Sri Lanka for postpartum mental health care, the current practices within antenatal mental health care have not been externally evaluated. The purpose of this study is to investigate the current clinical guidelines and experiences of how public health midwives diagnose and treat antenatal depression. Methods We conducted in-depth interviews with 12 public health midwives from four antenatal clinics in the Bope Poddala division in Galle, Sri Lanka and reviewed and extracted information on antenatal depression from clinical guidelines. Data was collected in Sinhala and translated into English. We used applied thematic analysis and worked closely with our local team to ensure data trustworthiness. Results Midwives (n = 12) reported varying degrees of knowledge on antenatal depression and did not have standardized diagnosis patterns. However, they were very consistent in their clinical practices, following guidelines for referral and follow-up of case management, building strong rapport. In their practice, midwives continue to face challenges of lack of human resources and high stigma around mental illness. They suggested that that care could be improved with use of a standardized diagnostic tool, and easier access to specialist care. We found the clinical guideline on the diagnosis and treatment of antenatal depression is lacking key details on symptoms for appropriate diagnosis, but it clearly guides on how to navigate treatment. Conclusions Public health midwives are following the clinical guideline to refer pregnant women who need intervention for antenatal depression and follow-up for case management. However, there is a need for more specific and context-relevant guidelines, especially for diagnosis of antenatal depression. Formative research is needed to explore intervention strategies to improve antenatal depression management in Sri Lanka.

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Medical ethics: knowledge, attitude and practice among doctors in three teaching hospitals in Sri Lanka

Cited by 29 publications

References 17 publications

<p>Knowledge and Attitudes Towards Abortion and Euthanasia Among Health Students in Papua New Guinea</p>

<p>Knowledge and Attitudes Towards Abortion and Euthanasia Among Health Students in Papua New Guinea</p>

Does teaching medical ethics ensure good knowledge, attitude, and reported practice? An ethical vignette-based cross-sectional survey among doctors in a tertiary teaching hospital in Nepal

Antenatal depression in Sri Lanka: a qualitative study of public health midwives’ views and practices

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