engleski

Croatian Physicians' and Nurses' Experience with Ethical Issues in Clinical Practice

To assess ethical issues in everyday clinical practice among physicians and nurses of the University Hospital Rijeka, Croatia. We surveyed the entire population of internal medicine, oncology and intensive care specialists and associated nurses employed at the University Hospital Rijeka, Croatia (N=532). An anonymous questionnaire was used to explore the type and frequency of ethical dilemmas, rank of their difficulty, access and usage of ethics support services, training in ethics, and confidence about knowledge in ethics. Physicians (N=113, female 55%) ranged in age from 27 to 61, nurses (N=251, female 95%) ranged in age from 20 to 52. Most often ethical dilemmas were: uncertain or impaired decision-making capacity (physicians 66%, nurses 47%, P=0, 008), limitation of therapy at the end of life (physicians 60%, nurses 31%, P<0, 001), and disagreements among family members (physicians 47%, nurses 31%, P=0, 025). Most difficult ethical dilemmas were euthanasia/PAS (physicians 49%, nurses 52%) and limitation of therapy at the end of life (physicians 14%, nurses 18%). Only a minority reported ever using any kind of ethics support services (physicians 12%, nurses 3%, P=0, 001), or being very confident about knowledge in ethics (physicians 5%, nurses 6%). Similar ethical difficulties are present in clinical practice of both physicians and nurses, with important differences in access and usage of ethics support services. A need for systematic ethics educational activities was identified. Inclusion of individual ethics consultants in Croatian healthcare ethics support services is strongly advised.

bioethical issues ; ethics clinical ; ethics consultation ; attitude of health personnel

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