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Comparative Study
. 2012 Mar 16:13:2.
doi: 10.1186/1472-6939-13-2.

Ethical problems in pediatrics: what does the setting of care and education show us?

Jucélia Maria Guedert  1 , Suely Grosseman
Affiliations
Comparative Study

Ethical problems in pediatrics: what does the setting of care and education show us?

Jucélia Maria Guedert et al. BMC Med Ethics. .

Abstract

Background: Pediatrics ethics education should enhance medical students' skills to deal with ethical problems that may arise in the different settings of care. This study aimed to analyze the ethical problems experienced by physicians who have medical education and pediatric care responsibilities, and if those problems are associated to their workplace, medical specialty and area of clinical practice.

Methods: A self-applied semi-structured questionnaire was answered by 88 physicians with teaching and pediatric care responsibilities. Content analysis was performed to analyze the qualitative data. Poisson regression was used to explore the association of the categories of ethical problems reported with workplace and professional specialty and activity.

Results: 210 ethical problems were reported, grouped into five areas: physician-patient relationship, end-of-life care, health professional conducts, socioeconomic issues and health policies, and pediatric teaching. Doctors who worked in hospitals as well as general and subspecialist pediatricians reported fewer ethical problems related to socioeconomic issues and health policies than those who worked in Basic Health Units and who were family doctors.

Conclusions: Some ethical problems are specific to certain settings: those related to end-of-life care are more frequent in the hospital settings and those associated with socioeconomic issues and public health policies are more frequent in Basic Health Units. Other problems are present in all the setting of pediatric care and learning and include ethical problems related to physician-patient relationship, health professional conducts and the pediatric education process. These findings should be taken into consideration when planning the teaching of ethics in pediatrics.

Trial registration: This research article didn't reports the results of a controlled health care intervention. The study project was approved by the Institutional Ethical Review Committee (Report CEP-HIJG 032/2008).

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Figures

Figure 1
Figure 1
Prevalence Ratio: work in hospitals compared to work in the Basic Health Units (exposure) and presence of at least one report in the category of ethical problem (outcome). Note: Two outcomes were omitted: End of Life Care (not reported by family physicians) and Pediatric Education Process (CI very broad).
Figure 2
Figure 2
Prevalence Ratio: clinical practice is as pediatrician compared to clinical practice as family doctor (exposure) of at least one report in the category of ethical problem (outcome). Note: Two outcomes were omitted: End of Life Care (not reported by family physicians) and Pediatric Education Process (CI very broad).
Figure 3
Figure 3
Prevalence Ratio: medical specialty-general pediatrician or subspecialist pediatrician compared to family doctor (exposure) and presence of at least one report in the category of ethical problem (outcome). Note: Two outcomes were omitted: End of Life Care (not reported by family physicians) and Pediatric Education Process (CI very broad).
See this image and copyright information in PMC

References

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