Ethical Dilemmas and Decision Making Process in Emergency Departments: Experience of Physicians in Public Hospitals, Addis Ababa, Ehiopia.
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Date
2017-06
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Addis Ababa University
Abstract
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
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Keywords
Ethical dilemmas; Decision making process; Physicians; Emergency departments; public hospitals