Physicians' access to ethics support services in four European countries

Area of Science:

• Medical Ethics
• Healthcare Management
• Physician Education

Background:

• Clinical ethics support services are emerging across Europe.
• Optimizing these services requires aligning them with clinicians' ethical concerns.
• Understanding current access and utilization patterns is crucial for development.

Purpose of the Study:

• To assess general physicians' access to various ethics support services in four European countries.
• To identify factors influencing physicians' use of available ethics support.
• To inform the development of more effective clinical ethics support.

Main Methods:

• A cross-sectional mailed survey was administered to random samples of general physicians in Norway, Switzerland, Italy, and the UK.
• Data were collected on access to formal (committees, consultations, ethicists) and informal ethics support.
• Statistical analysis identified factors associated with service utilization.

Main Results:

• Access to formal ethics support was limited (e.g., committees 23%, consultations 17.6%) and associated with urban hospital work.
• Informal ethics resources were more widely distributed.
• Despite 81% finding support useful, only 14% reported using available services. Confidence in ethics knowledge and prior ethics education increased usage.

Conclusions:

• General physicians in Europe utilize a mix of formal and informal resources for ethical challenges.
• Integrating informal support and enhancing medical school ethics education may improve physician engagement with ethics services.
• Proactive outreach by ethics support services is needed to increase their availability and use.