This study is a cross sectional self-administered mailed survey to address the type and frequency of ethical dilemmas faced by physicians, how they approach them, the types of ethical support they would find useful in addressing these ethical dilemmas, and their attitudes and practices in situations of scarce resources. The questionnaire was designed, piloted, translated and back translated. Following IRB approval, the study sample included 656 general practitioners and general internists from each of four European countries including England, Switzerland, Norway and Italy. The results have been analyzed and five peer reviewed journal articles have been published and two book chapters have been published. ? These publications report:? 1. The ethical difficulties encountered in clinical Practice by European doctors.? 2. Physicians access to ethics support services in the four european countries in the study.? 3. The prevalence and determinants of physician bedside rationing in four European countries.? 4. Physicians views on resource availability and equity in four European health care systems. ? 5. An examination of whether ethics consultants should help clinicians face scarcity in their Practices.? The study has been amended to include 700 Sri Lankan physicians for comparison with the European sample. IRB approval has been attained at the NIH for the Sri Lankan survey.

Agency
National Institute of Health (NIH)
Institute
Clinical Center (CLC)
Type
Intramural Research (Z01)
Project #
1Z01CL010518-07
Application #
7733640
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
7
Fiscal Year
2008
Total Cost
$16,630
Indirect Cost
Name
Clinical Center
Department
Type
DUNS #
City
State
Country
United States
Zip Code
Hurst, S A; Perrier, A; Pegoraro, R et al. (2007) Ethical difficulties in clinical practice: experiences of European doctors. J Med Ethics 33:51-7
Hurst, Samia A; Forde, Reidun; Reiter-Theil, Stella et al. (2007) Physicians'views on resource availability and equity in four European health care systems. BMC Health Serv Res 7:137
Hurst, Samia A; Reiter-Theil, Stella; Perrier, Arnaud et al. (2007) Physicians'access to ethics support services in four European countries. Health Care Anal 15:321-35
Hurst, Samia A; Slowther, Anne-Marie; Forde, Reidun et al. (2006) Prevalence and determinants of physician bedside rationing: data from Europe. J Gen Intern Med 21:1138-43