title: Clinical ethical dilemmas for vascular surgeons (the VASCUETHICS study): are self-interest attitudes related to professional seniority?
abstract: OBJECTIVE
  To evaluate the association between professional seniority and self-interest (PSI) attitudes in the resolution of vascular ethical dilemmas (VED).
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Vascular surgeons (residents included) from the 28 vascular teaching departments of Spain. Measurements. Multidisciplinary team-designed questionnaire of 5 VED. Each VED had 3 different answers (attitudes): 2 favouring legitimate ethical attitudes (LEA) and 1 favouring PSI. The questionnaire was self-administered and all participants stated their degree of agreement with each answer on a continuous Likert scale. PSI was evaluated by: (1) adding the magnitudes of the 5 answers favouring PSI (absPSI); and (2) by comparing in each case the magnitude of the PSI answer with that of the 2 LEA (relPSI).
  
  
  METHODS
  Linear regression adjusted by confounding factors.
  
  
  RESULTS
  Two hundred and fifty-three vascular surgeons from the 26 participating teaching vascular departments of public hospitals completed the questionnaire (87.5% surgeons/department). Surgeon characteristics were: (1) median age 37 years; (2) 187 (74%) male; (3) 59 (23%) brought up with a health professional relative; (4) 94 (38%) had additional private practice; (5) 133 (65%) professed religious beliefs; and (6) 1-10 years of experience in 116 (47%), 11-20 years in 58 (24%), 21-30 years in 57 (23%), and >30 years in 15 (6%). The multivariate analysis disclosed that for every 10-years rise in professional seniority there was a 3.2% increase in absPSI (p=0.007, adjusted by variables 3 and 4), and a 3.4% increase in relPSI (p=0.002, adjusted by variable 5).
  
  
  CONCLUSIONS
  Professional seniority is associated with a slight increase in pro-PSI attitudes in cases of vascular ethical dilemma. Both vascular surgeons and health institutions should promote the reversal of this worrying tendency.
authors.affiliation: Department of Vascular Surgery, Hospital del Mar, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Clará
authors.forename: A
authors.initials: A
authors.lastname: Ysa
authors.forename: B
authors.initials: B
authors.lastname: Román
authors.forename: M
authors.initials: M
authors.lastname: Anglés
authors.forename: F
authors.initials: F
authors.lastname: Vidal-Barraquer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004992:Ethics, Medical; D005260:Female; D013502:General Surgery / Q000941:ethics*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D010820:Physicians / Q000523:psychology*; D011364:Professional Practice; D013030:Spain; D011795:Surveys and Questionnaires