NIH Clinical Research Studies

Protocol Number: 02-CC-0247

Active Accrual, Protocols Recruiting New Patients

Title:
Values at the Bedside: A Survey of European Physicians Regarding Ethical Dilemmas in Clinical Practice
Number:
02-CC-0247
Summary:
This study will survey a random sample of 2,100 general medicine physicians in Europe and in the U.S. about ethical difficulties they face in their practice of medicine. The participants will complete a questionnaire designed to meet the following study objectives:

- Identify the types of ethical dilemmas physicians report that they face in their practice and approaches they find helpful in responding to these situations

- Determine what ethical support physicians would find useful in dealing with ethically problematic situations

- Explore physicians' experience with 'bedside rationing', due to economic or societal constraints, what procedures they forgo as a result, and what criteria they use in their rationing decisions

- Explore physicians perceptions of the equity of the health care system they work in

- Determine what interventions directed at limiting health care costs physicians would find acceptable.

Physicians in Italy, Norway, Switzerland and the United Kingdom who practice direct patient care for at least 20 percent of their time may enroll in this study.

The practice of medicine sometimes involves situations where important values come into conflict. The refusal of life-saving treatment, the concern that telling the truth could have problematic consequences, acceptable ways of facing a request to die-all are examples of dilemmas that can arise in the practice of medicine. The absence of clear-cut 'right answers' to questions raised by these situations have led to the development of support services, such as ethics consultations, to help in decision-making concerning ethical problems that arise in clinical settings. Information from this survey can provide input into the continuing development of ethics support services by establishing an evidence base regarding the ethical difficulties encountered by physicians and the type of support they would consider useful in resolving these dilemmas.

Sponsoring Institute:
National Institutes of Health Clinical Center (CC)
Recruitment Detail
Type: Participants currently recruited/enrolled
Gender: Male & Female
Referral Letter Required: Yes
Population Exclusion(s): Children

Eligibility Criteria:
INCLUSION CRITERIA:

Physician in Italy, Norway, Switzerland, the UK, and the U.S.

Clinical activity in Primary Care or Internal Medicine.

EXCLUSION CRITERIA:

Physicians who are not in direct patient care for at least 20% of their time.

Physicians who have not been in direct patient care for at least one year immediately prior to the study.

Special Instructions:
Currently Not Provided
Keywords:
Ethics, Clinical
Physician's Role
Health Care Rationing
Knowledge, Attitudes, Practices
Questionnaires
Recruitment Keyword(s):
Survey
Ethics
Condition(s):
Ethics
Investigational Drug(s):
None
Investigational Device(s):
None
Intervention(s):
None
Supporting Site:
Warren G. Magnuson Clinical Center

Contact(s):
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citation(s):
Day JR, Smith ML, Erenberg G, Collins RL. An assessment of a formal ethics committee consultation process. HEC Forum. 1994 Jan;6(1):18-30. No abstract available.

Orr RD, Moon E. Effectiveness of an ethics consultation service.J Fam Pract. 1993 Jan;36(1):49-53.

Schneiderman LJ, Gilmer T, Teetzel HD. Impact of ethics consultations in the intensive care setting: a randomized, controlled trial. Crit Care Med. 2000 Dec;28(12):3920-4.

Active Accrual, Protocols Recruiting New Patients

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