title: Ethical concerns and dilemmas of Finnish and Dutch health professionals.
abstract: BACKGROUND
  Healthcare professionals encounter ethical dilemmas and concerns in their practice. More research is needed to understand these ethical problems and to know how to educate professionals to respond to them.
  
  
  OBJECTIVE
  To describe ethical dilemmas and concerns at work from the perspectives of Finnish and Dutch healthcare professionals studying at the master's level.
  
  
  METHODS
  Exploratory, qualitative study that used the text of student online discussions of ethical dilemmas at work as data.
  
  
  METHODS
  Participants' online discussions were analyzed using inductive content analysis.
  
  
  METHODS
  The sample consisted of 49 students at master's level enrolled in professional ethics courses at universities in Finland and the Netherlands.
  
  
  METHODS
  Permission for conducting the study was granted from both universities of applied sciences. All students provided their informed consent for the use of their assignments as research data.
  
  
  RESULTS
  Participants described 51 problematic work situations. Among these, 16 were found to be ethical dilemmas, and the remaining were work issues with an ethical concern and did not meet criteria of a dilemma. The most common problems resulted from concerns about quality care, safety of healthcare professionals, patients' rights, and working with too few staff and inadequate resources.
  
  
  CONCLUSIONS
  The results indicated that participants were concerned about providing quality of care and raised numerous questions about how to provide it in challenging situations. The results show that it was difficult for students to differentiate ethical dilemmas from other ethical work concerns.
  
  
  CONCLUSIONS
  Online discussions among healthcare providers give them an opportunity to relate ethical principles to real ethical dilemmas and problems in their work as well as to critically analyze ethical issues. We found that discussions with descriptions of ethical dilemmas and concerns by health professionals provide important information and recommendations not only for education and practice but also for health policy.
authors.affiliation: JAMK University of Applied Sciences, Finland hanna.hopia@jamk.fi.
authors.forename: Hanna
authors.initials: H
authors.lastname: Hopia
authors.affiliation: University of Maryland, Baltimore County, USA.
authors.forename: Ilsa
authors.initials: I
authors.lastname: Lottes
authors.affiliation: University of Applied Sciences Utrecht, The Netherlands.
authors.forename: Mariël
authors.initials: M
authors.lastname: Kanne
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004500:Education, Graduate; D004992:Ethics, Medical; D005260:Female; D005387:Finland; D006282:Health Personnel / Q000941:ethics / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D028701:Patient Rights / Q000941:ethics; D011369:Professional-Patient Relations / Q000941:ethics; D036301:Qualitative Research; D011787:Quality of Health Care / Q000941:ethics
keywords: Content analysis; ethical concern; ethical dilemma; healthcare master’s degree; professional ethics education