title: Chinese physicians' attitudes toward and understanding of medical professionalism: results of a national survey.
abstract: BACKGROUND
  Medical professionalism has been developing in the Peoples' Republic of China as one way to better address perennial and new challenges in healthcare in an ever-changing society. Among many recent developments in this area is promotion by the national Chinese Medical Doctor Association of the principles and values contained in the international document, "Medical Professionalism in the New Millennium: A Physician Charter."
  
  
  OBJECTIVE
  To discover Chinese physicians' attitudes toward and understanding of medical professionalism.
  
  
  METHODS
  The authors distributed a self-reporting questionnaire that included 34 statements and four case scenarios concerning the general principles of medical professionalism: the primacy of patients' welfare, respect for patients' autonomy, promotion of social justice, and professional self-regulation. The questionnaire included controversial issues such as the role of the family in decision making and reporting medical errors. A total of 2,966 practicing physicians, randomly selected from the Chinese Medical Association database, were surveyed, and 1,198 valid questionnaires were returned. Our sample covered 23 provinces and 51 cities throughout the Peoples' Republic of China.
  
  
  RESULTS
  More than 80 percent of the physicians who responded agreed that the physician-patient relationship should be a relationship of trust founded on professional altruism, and that informed consent is necessary. More than 95 percent agreed that physicians should promote professional self-regulation as well as social justice. More than half agreed with the principle of the primacy of patients' welfare (62.8 percent), and that physicians have a responsibility to report medical errors and incompetent colleagues (51.0 percent). In certain cases, a great majority of Chinese physicians favored familism and paternalism.
  
  
  CONCLUSIONS
  The study does not include data on how Chinese physicians practice medical professionalism, or the perspectives of physicians working in smaller cities and in rural areas.
  
  
  CONCLUSIONS
  Based on responses to the survey, Chinese physicians strongly support the majority of the fundamental principles and responsibilities of medical professionalism, including dedication, altruism, social justice, self-regulation, and informed consent. However, their support for the primacy of patients' welfare as a general principle, and the physician's responsibility to report medical errors and incompetent colleagues, is relatively low. To help advance medical professionalism in the People's Republic of China, professional development programs and medical ethics education should not only emphasize the general principles involved, but also formulate guidelines on how these principles can be carried out in practice.
authors: Division of Medical Ethics, Institute for Medical Humanities Peking University, No.38 Xueyuan Rd., Haidian, Beijing, 100191 Peoples' Republic of China. hulinying@bjmu.edu.cn.
authors: Linying
authors: L
authors: Hu
authors: Division of Medical Ethics, Institute for Medical Humanities Peking University, No.38 Xueyuan Rd., Haidian, Beijing, 100191 Peoples' Republic of China.
authors: Xiuyun
authors: X
authors: Yin
authors: Division of Medical Ethics, Institute for Medical Humanities Peking University, No.38 Xueyuan Rd., Haidian, Beijing, 100191 Peoples' Republic of China.
authors: Xiaolei
authors: X
authors: Bao
authors: Bioethics Centre of the University of Otago, Dunedin, New Zealand.
authors: Jin-Bao
authors: JB
authors: Nie
mesh_terms: D000328:Adult; D000533:Altruism; D044466:Asian People / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D026688:Bioethical Issues; D002681:China / Q000453:epidemiology; D032882:Comprehension; D003466:Cultural Characteristics; D004992:Ethics, Medical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D026706:Paternalism; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000941:ethics* / Q000523:psychology / Q000706:statistics & numerical data*; D012935:Social Justice; D014481:United States