Which are the most prevalent ethical conflicts for Spanish internists?

Area of Science:

• Medical Ethics
• Clinical Practice
• Healthcare Professionalism

Background:

• Clinicians frequently face ethical dilemmas in daily practice.
• No prior studies have detailed the most common and concerning ethical conflicts for clinicians in Spain.
• This study addresses a gap in understanding the ethical landscape for Spanish internists.

Purpose of the Study:

• To identify and report the most frequent ethical conflicts encountered by Spanish internists.
• To assess the level of importance Spanish internists attribute to various ethical conflicts.
• To provide insights into the ethical challenges within internal medicine in Spain.

Main Methods:

• An observational, cross-sectional study design was employed.
• A voluntary and anonymous survey was administered to Spanish medical internists.
• The survey was distributed via a dedicated platform of the Spanish Society of Internal Medicine.

Main Results:

• The most prevalent and significant ethical issues involve end-of-life care (therapeutic limitation, palliative care, DNR orders).
• Conflicts within the doctor-patient/family relationship and managing noncompetent patients are also highly relevant.
• Clinicians who perceive these ethical problems (50.3%) are more numerous than those who do not (16%).

Conclusions:

• End-of-life care, doctor-patient relationships, and managing noncompetent patients represent the primary ethical conflicts for Spanish internists.
• These findings align with international studies from English and European contexts.
• Developing targeted training programs is crucial for improving clinicians' recognition and management of these ethical issues.