title: Survey on the experience in ethical decision-making and attitude of Pleven University hospital physicians towards ethics consultation.
abstract: BACKGROUND
  Contemporary medical practice is complicated by many dilemmas requiring ethical sensitivity and moral reasoning.
  
  
  OBJECTIVE
  To investigate physicians' experience in ethical decision-making and their attitude towards ethics consultation.
  
  
  METHODS
  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.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Public Health, University of Medicine, Pleven, Bulgaria. aleksandrova_silviya@yahoo.com
authors.forename: Silviya
authors.initials: S
authors.lastname: Aleksandrova
mesh_terms: D001294:Attitude to Health; D002031:Bulgaria; D003657:Decision Making / Q000941:ethics*; D026822:Ethicists; D033061:Ethics Consultation; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics; D012959:Socioeconomic Factors