title: Managing ethical issues in patient care and the need for clinical ethics support.
abstract: OBJECTIVE
  To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia.
  
  
  METHODS
  A cross-sectional survey was conducted of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals.
  
  
  RESULTS
  Some respondents did not provide data for some questions, therefore the denominator is less than 105 for some items. Sixty-two (62/104; 60%) respondents reported occasionally to often having ethical concerns. Forty-six (46/105; 44%) reported often to occasionally having legal concerns. The three most common responses to concerns were: talking to colleagues (96/105; 91%); raising the issue in a group forum (68/105; 65%); and consulting a relevant guideline (64/105; 61%). Most respondents were highly (65/99; 66%) or moderately (33/99; 33%) satisfied with the ethical environment of the hospital. Twenty-two (22/98; 22%) were highly satisfied with the ethical environment of their department and 74 (74/98; 76%) were moderately satisfied. Most (72/105; 69%) respondents indicated that additional support in dealing with ethical issues would be helpful.
  
  
  CONCLUSIONS
  Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. Although this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, most respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia.
authors.affiliation: Centre for Values, Ethics and Law in Medicine, University of Sydney, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2006, Australia. Email: ;
authors.forename: Evan
authors.initials: E
authors.lastname: Doran
authors.affiliation: Centre for Values, Ethics and Law in Medicine, University of Sydney, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2006, Australia. Email: ;
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fleming
authors.affiliation: Centre for Values, Ethics and Law in Medicine, University of Sydney, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2006, Australia. Email: ;
authors.forename: Christopher
authors.initials: C
authors.lastname: Jordens
authors.affiliation: Centre for Health Governance, Law and Ethics, University of Sydney, New Law Building, Camperdown, NSW 2006, Australia. Email.
authors.forename: Cameron L
authors.initials: CL
authors.lastname: Stewart
authors.affiliation: Office of the Chief Health Officer, NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia. Email.
authors.forename: Julie
authors.initials: J
authors.lastname: Letts
authors.affiliation: Centre for Values, Ethics and Law in Medicine, University of Sydney, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW 2006, Australia. Email: ;
authors.forename: Ian H
authors.initials: IH
authors.lastname: Kerridge
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D026690:Ethics, Clinical; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D005791:Patient Care / Q000941:ethics*; D055815:Young Adult