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Between professional values, social regulations and patient preferences: medical doctors' perceptions of ethical dilemmas
  1. Berit Bringedal1,
  2. Karin Isaksson Rø1,
  3. Morten Magelssen2,
  4. Reidun Førde2,
  5. Olaf Gjerløv Aasland1
  1. 1LEFO, Institute for Studies of the Medical Profession, Oslo, Norway
  2. 2Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Oslo, Norway
  1. Correspondence to Dr Berit Bringedal, LEFO, Institute for Studies of the Medical Profession, Oslo 0107, Norway; berit.bringedal{at}legeforeningen.no

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.

  • clinical ethics
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Footnotes

  • Contributors All authors have collaborated in all phases of the project. OGA initiated the survey, and all authors discussed its contents. OGA, KIR and BB collaborated in implementing the survey. BB wrote the first draft of the paper, and all authors contributed in its further devleopment, including the revision.

  • Competing interests None declared.

  • Ethics approval The Regional Committee for Medical Research Ethics has exempted the survey from review since it does not include patient data (approval no IRB 0000 1870).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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