Top 10 health care ethics challenges facing the public: views of Toronto bioethicists.
BACKGROUND
There are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. The panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds.


CONCLUSIONS
The top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill.


CONCLUSIONS
Although many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge.
University of Toronto Joint Centre for Bioethics, 88 College Street, Toronto, Ontario, M5G 1L4, Canada. jonathan.breslin@utoronto.ca.
Jonathan M
JM
Breslin
Susan K
SK
MacRae
Jennifer
J
Bell
Peter A
PA
Singer
D001290:Attitude; D026688:Bioethical Issues; D020811:Biomedical Technology / Q000941:ethics; D002170:Canada; D034462:Dissent and Disputes; D026822:Ethicists / Q000523:psychology*; D026690:Ethics, Clinical; D005066:Euthanasia, Passive / Q000941:ethics; D005190:Family; D006292:Health Priorities / Q000941:ethics; D006297:Health Services Accessibility / Q000941:ethics; D007258:Informed Consent / Q000941:ethics; D019300:Medical Errors; D018447:Medical Futility; D010817:Physician-Patient Relations; D011368:Professional-Family Relations / Q000941:ethics; D019727:Proxy; D013727:Terminal Care / Q000941:ethics; D014850:Waiting Lists