title: Attitudes of rehabilitation medicine doctors toward medical ethics in Malaysia.
abstract: BACKGROUND
  Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care.
  
  
  METHODS
  We surveyed 74 rehabilitation physicians and residents in Malaysia using a self-administered descriptive questionnaire. The questions covered medical ethics issues on allocation of resources, patient confidentiality, discharge planning, goal-setting, reimbursement documentation, decision-making capacity and withdrawal of life support.
  
  
  RESULTS
  The overall response rate was 69 percent. More than 80 percent of respondents would disclose confidential information to their team members if it would affect the rehabilitation process. More than two-thirds of respondents would not allocate scarce rehabilitation resources if the functional outcome is marginally positive. Issues involving patients' autonomy in decision-making, both in life-threatening and non-life-threatening situations, showed mix responses. The least common response was on the issue of discharge planning, where 51 percent of respondents would send a patient back to a nursing home with suboptimal care if there were no other alternatives.
  
  
  CONCLUSIONS
  The attitude of Malaysian rehabilitation doctors toward ethical issues is reflective of the level of maturity of rehabilitation medicine in Malaysia. Issues on allocation of resources, discharge planning and decision-making capacity are significantly influenced by limited rehabilitation facilities in parts of the country. The lack of influence from external factors, such as a developed health insurance system, contributes to the difference in attitude between rehabilitation doctors in Malaysia and those in developed countries.
authors: Department of Rehabilitation Medicine, 2nd Floor, Block R, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. drmazlina@gmail.com
authors: M
authors: M
authors: Mazlina
authors: P E
authors: PE
authors: Julia
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003219:Confidentiality; D003657:Decision Making; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D012046:Rehabilitation / Q000941:ethics* / Q000379:methods*; D011795:Surveys and Questionnaires