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Med Health Care Philos. 2008 Mar;11(1):35-42. Epub 2007 Oct 2.

Survey on the experience in ethical decision-making and attitude of Pleven University hospital physicians towards ethics consultation.

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Department of Social and Preventive Medicine, Faculty of Public Health, University of Medicine, Pleven, Bulgaria.



Contemporary medical practice is complicated by many dilemmas requiring ethical sensitivity and moral reasoning.


To investigate physicians' experience in ethical decision-making and their attitude towards ethics consultation.


In a cross-sectional survey 126 physicians representing the main clinics of Pleven University hospital were investigated by a self-administered questionnaire. The following variables were measured: occurrence, nature and ways of resolving ethical problems; physicians' attitudes towards ethics consultation; physicians' opinions on qualities and skills of an ethics consultant, and socio-demographic characteristics. Data analysis included descriptive statistics, chi(2 )and t-test.


Response rate was 88.9% (n = 112). Men and women were equally represented (48.2%-51.8%). The sample consisted of experienced physicians: 42.9% had 11-20 years experience, and 33% had 21-30 years. According to 84.8% of respondents, ethical problems have been discussed in their specialty. Predominant dilemmas included relationships with patients and relatives (76.8%) and team work (67.6%). Over (3/4) of physicians needed an advice in solving ethical problems. Ninety six percent responded positively to ethics consultation. They would mainly request it for resolving conflicts (72.5%), and in case of concern for the rightness of their decisions (52.7%). The image of an ethics consultant was built of clinical competence (70.9%), ability to deal with conflicts (59.1%), communication skills (58.2%), tolerance for different views (55.4%), and a special qualification in ethics (52.7%).


The study underlined that Pleven University hospital physicians face similar ethical dilemmas as their colleagues in other countries do. The expressed positive attitudes to ethics consultation should serve as a basis for further research and development of ethics consultation services.

[Indexed for MEDLINE]

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