Ethical Dilemmas and Decision Making Process in Emergency Departments: Experience of Physicians in Public Hospitals, Addis Ababa, Ehiopia.

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Addis Ababa University


Background: Ethical dilemmas routinely arise at emergency departments in hospital setting. Physicians, patients and patient families are face a problem of choice and decision making become difficult in terms of ethics. There are also numbers of ethical dilemmas in emergency care; because it is different from other department in terms of need of quick intervention to save life, unknown history of patient, scarce resources, family culture and/ or beliefs, and emergency department crowdedness. Objectives: To assess ethical dilemmas and decision making process in emergency departments of public hospitals: experiences of physicians working in public hospitals, Addis Ababa, Ethiopia. Methods: Institutional based descriptive cross-sectional study using a self-administered, structured questionnaire. Result. The study included 106 physicians of which 62(58.5%) male and 44(41.5%) female. From open ended questions physicians were asked the most common ethical dilemmas they encountered in emergency department and 42 physicians 21(50%) respond that it is against medical advice due to economic problem, 12(28.5%) decision for unconscious patient with no family and 9 (21.5%) disagreement with family on treatment option for unconscious patient. Nearly 72% 0f physicians encounter ethical dilemmas in emergency departments because there is no guideline for the admission of patient to intensive care unit and operation room. Conclusion: Physicians routinely challenge with ethical dilemmas and face difficult decision making process in emergency department during their medical practices. The main sources of ethical conflict in the department are scarce resource, treatment option for unconscious patient with no family members, disagreement of family and physician on treatment option for unconscious patient and having many patients or emergency room crowdedness. Key words: Ethical dilemmas, decision making process, physicians, emergency departments, public hospitals



Ethical dilemmas; Decision making process; Physicians; Emergency departments; public hospitals