title: [Ethical issues perceived by health care professionals working in chronic hemodialysis centers].
abstract: BACKGROUND
  Clinical teams working at chronic hemodialysis centers (CHC) frequently have to face ethical problems, but there is no systematic approach to deal with them.
  
  
  OBJECTIVE
  To study the ethical problems perceived by health professionals at CHC.
  
  
  METHODS
  Eighty randomly selected physicians and 139 nurses from 23 CHC, answered a structured questionnaire, devised by the research team.
  
  
  RESULTS
  Twenty-six percent of respondents had postgraduate studies in clinical ethics. The ethical problems mentioned by respondents were therapeutic disproportion in 66.7%, lack of communication between patients, their families and the clinical team in 25.9%, personal conflicts of interests related with hemodialysis prescription in 14.6% and conflicts of interests of other members of the clinical team in 30.6%. The percentage of respondents that experienced not starting or discontinuing hemodialysis treatment due to decision of patients relatives was 86.8%. Only 45.2% of health professionals had the opportunity to take part in decision-making meetings. Eighty seven percent of respondents supported the use of advanced directives in the event of a cardio respiratory arrest during treatment.
  
  
  CONCLUSIONS
  To improve the approach to ethical problems in CHC, it is necessary to improve training in clinical ethics, promote an effective dialogue between the patients, their families and health professionals, and follow their advance directives in case of cardiac arrest during treatment.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vukusich
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Catoni
authors.forename: Sofía P
authors.initials: SP
authors.lastname: Salas
authors.forename: Andrés
authors.initials: A
authors.lastname: Valdivieso
authors.forename: Francisca
authors.initials: F
authors.lastname: Browne
authors.forename: Emilio
authors.initials: E
authors.lastname: Roessler
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D026688:Bioethical Issues; D003430:Cross-Sectional Studies; D003657:Decision Making / Q000941:ethics; D004522:Educational Status; D005260:Female; D006282:Health Personnel / Q000941:ethics*; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000941:ethics*; D011795:Surveys and Questionnaires