The first nationwide study on facing and solving ethical dilemmas among healthcare professionals in Slovenia

Abstract

Background Healthcare professionals (HCPs), patients and families are often faced with ethical dilemmas. The role of healthcare ethics committees (HECs) is to offer support in these situations. Aim The primary objective was to study how often HCPs encounter ethical dilemmas. The secondary objective was to identify the main types of ethical dilemmas encountered and how HCPs solve them. Subjects and methods We conducted a cross-sectional, survey-based study among HCPs in 14 Slovenian hospitals. A questionnaire was designed and validated by HCPs who were selected by proportional stratified sampling. Data collection took place between April 2015 and April 2016. Results The final sample size was n = 485 (385 or 79.4%, female). The response rates for HCPs working in secondary and tertiary level institutions were 45% and 51%, respectively. Three hundred and forty (70.4%) of 485 HCPs (very) frequently encountered ethical dilemmas. Frequent ethical dilemmas were waiting periods for diagnostics or treatment, suboptimal working conditions due to poor interpersonal relations on the ward, preserving patients' dignity, and relations between HCPs and patients. Physicians and nurses working in secondary level institutions, compared to their colleagues working in tertiary level institutions, more

Tough Clinical Decisions: Experiences of Polish Physicians

“…However, this study also reveals that Polish physicians are less likely to face or admit facing tough clinical decisions than their peers from the United States and western or northern European countries. Slightly above three quarters of our respondents (76.6%) reported confronting tough clinical decisions, whereas in similar studies with US physicians practicing general internal medicine, hematology/oncology, or critical care/pulmonary medicine (DuVal et al, 2004), general practitioners from Great Britain, Italy, Norway, and Switzerland (Hurst et al, 2007) and physicians from Croatia and Slovenia (Grosek at al. 2020;Grosek et al, 2021), almost all surveyed doctors (90% or above) reported having such an experience.…”

“…Grosek et al, 2021 ). In a Slovenian study, ethical dilemmas associated with “long waiting periods for diagnostic and therapeutic treatment” and/or “allocation of limited resources” were indicated by 69.7% and 37.3% of the surveyed physicians, respectively (Grosek et al, 2020 ). However, only 20% of U.S. doctors indicated allocation as a source of ethical problems (Hurst et al, 2005 ).…”

“…The need for comparative data from countries with different sociopolitical histories and healthcare systems, especially those from central and eastern Europe, has been strongly emphasized in the literature (Hurst et al, 2007;cf. Sorta-Bilajac et al, 2008;Grosek et al, 2020;Grosek et al, 2021). This paper responds to this need by reporting results of the very first empirical study on Polish physicians' experiences with -what we have called -tough clinical decisions, i.e., decisions about the patient's treatment or care that Polish physicians consider difficult to make for moral reasons or other reasons not directly related to their medical knowledge or skills, e.g., communication or other interpersonal problems, limited resources, organizational issues, or legal requirements (Czarkowski et al, 2021;Kälvemark et al, 2004).…”

Need to revisit ethics training of doctors for effectively serving rural communities; a review

“…7 With the advent of new innovations in medicine a variety of ethical issues are faced by healthcare professionals in different settings involving their own personal values, the values of the institution, and the ethical, legal, and cultural values of society. 8 It has been seen through research those various ethical problems arising in different regions of the world need handling in different ways. When problems faced by Native Americans were analyzed it was found that due to the influence of various ethnic origins and isolation from the U.S. and trauma faced by them in history during colonization; competent healthcare providers were needed to deal with their specific issues.…”

What Ethical Dilemmas Do Social Workers Face in the Healthcare Area in Spain?

“…Studies have been carried out in the healthcare area, although limited to medicine and nursing, that have highlighted the importance of giving professionals in medicine and nursing strategies for analysing and resolving ethical dilemmas that allow them to anticipate and reduce stress in their work (Corley, Minick, Elswick, & Jacobs, 2005;Førde & Aasland, 2008;Häggström, Mbusa, & Wadensten, 2008;Hofmeyer, 2003;Rathert, May, & Chung, 2016;Rushton, Kaszniak, & Halifax, 2013;Wadensten, Wenneberg, Silén, Tang, & Ahlström, 2008), but nothing specific to strategies for analysing and resolving them specifically (Barlow, Hargreaves, & Gillibrad, 2008;Bolin et al, 2008;Grosek et al, 2020;Kanofsky, 2020).…”