Physicians' access to ethics support services in four European countries.
Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P=0.001), or who had had ethics courses in medical school (P=0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensitivity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available.
Hurst
Samia A
SA
Institute for Biomedical Ethics, Medical Faculty, University of Geneva, Geneva, Switzerland.
Reiter-Theil
Stella
S
Perrier
Arnaud
A
Forde
Reidun
R
Slowther
Anne-Marie
AM
Pegoraro
Renzo
R
Danis
Marion
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D028741:Ethics Committees, Clinical / Q000706:statistics & numerical data*; D033061:Ethics Consultation / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged