Which are the most prevalent ethical conflicts for Spanish internists?

Area of Science:

• Medical Ethics
• Internal Medicine
• Clinical Practice

Background:

• Clinicians regularly face ethical dilemmas.
• No prior studies detailed frequent ethical conflicts for Spanish internists.
• This study addresses a gap in understanding ethical challenges in Spanish internal medicine.

Purpose of the Study:

• To identify and rank the most common ethical conflicts experienced by Spanish internists.
• To assess the perceived importance of these ethical conflicts among practitioners.
• To provide data for improving ethical training and support for internists.

Main Methods:

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

Main Results:

• End-of-life care decisions (limiting therapy, palliative care, DNR orders) were the most frequent and relevant ethical issues.
• Conflicts within the doctor-patient/family relationship and managing noncompetent patients were also significant.
• Over 50% of clinicians noticed these ethical problems, compared to 16% who did not.

Conclusions:

• End-of-life management, doctor-patient dynamics, and noncompetent patient care are primary ethical concerns for Spanish internists.
• These findings align with international studies from English and European series.
• Enhanced training programs are crucial for equipping clinicians to better recognize and manage ethical conflicts.