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Ethical Dilemmas in Physicians' Consultations with COPD Patients
Jonina Sigurgeirsdottir1,2, Sigridur Halldorsdottir3, Ragnheidur Harpa Arnardottir3,4,5
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Summary
Physicians face ethical dilemmas when managing COPD patients, balancing treatment adherence with patient autonomy. Strategies include education and interdisciplinary support to motivate self-management in chronic obstructive pulmonary disease.
Area of Science:
- Medical Ethics
- Pulmonology
- Qualitative Research
Background:
- Managing Chronic Obstructive Pulmonary Disease (COPD) requires physicians to motivate patients towards self-management.
- The GOLD clinical guidelines provide a framework for COPD therapy.
Purpose of the Study:
- To explore principal physicians' experiences in managing COPD patients.
- To understand challenges in motivating COPD self-management.
- To identify ethical dilemmas faced by physicians.
Main Methods:
- Phenomenological study involving nine physicians (GPs and lung specialists).
- Semi-structured interviews were conducted, recorded, and transcribed.
- Data analyzed through deconstruction and reconstruction.
Main Results:
- Physicians encountered ethical dilemmas balancing patient autonomy with promoting health, especially regarding smoking cessation.
- Challenges included addressing nicotine addiction, patient denial, and motivating disease mastery.
- Strategies employed included patient education, enhancing intrinsic motivation, interdisciplinary approaches, involving family, and recommending Pulmonary Rehabilitation (PR).
Conclusions:
- Motivating COPD self-management presents a balancing act for physicians, fraught with ethical dilemmas.
- Physicians must navigate patient nicotine addiction and their ethical duty to respect patient autonomy, even when it conflicts with optimal care.
- The study highlights physician-suggested strategies for enhancing COPD patient self-management.
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