How nurses and physicians face ethical dilemmas--the Croatian experience

Area of Science:

• Medical Ethics
• Clinical Practice
• Healthcare Professionals

Background:

• Ethical dilemmas are inherent in clinical practice, impacting healthcare professionals.
• Understanding the specific ethical challenges faced by nurses and physicians is crucial for improving patient care and professional support.
• The utilization of clinical ethics consultations (CECs) varies, necessitating an evaluation of their accessibility and effectiveness.

Purpose of the Study:

• To assess and compare the ethical dilemmas encountered by nurses and physicians in clinical practice.
• To identify the primary ethical issues, satisfaction with resolutions, and perceived usefulness of available help.
• To evaluate the current usage of clinical ethics consultations among healthcare professionals.

Main Methods:

• A survey was administered to 364 nurses and physicians at the Clinical Hospital Centre Rijeka.
• The questionnaire collected data on recent ethical dilemmas, primary ethical issues, satisfaction with resolutions, perceived usefulness of help, and usage of clinical ethics consultations.
• Data analysis focused on identifying commonalities and differences in ethical challenges and support needs.

Main Results:

• Nurses reported professional conduct dilemmas (8%), while physicians reported near-end-of-life decisions (27%) as recent ethical dilemmas.
• Limiting life-sustaining therapy was a primary ethical issue for both groups (nurses 15%, physicians 24%), alongside euthanasia and physician-assisted suicide (nurses 16%, physicians 9%).
• Nurses and physicians reported similar needs for obtaining complete patient information and clarifying ethical issues; however, the usage of clinical ethics consultations was low.

Conclusions:

• Nurses and physicians encounter comparable ethical dilemmas in their clinical practice.
• The low utilization of clinical ethics consultations indicates a potential barrier to accessing ethical support.
• It is recommended to implement individual and team-based consultations within Croatian clinical ethics consultation services to enhance support for healthcare professionals.