U.S. physicians are deeply divided on many ethical decisions that could significantly impact patients and their families, according to a survey conducted by WebMD Health Corp, a prominent web source of health information.
Medscape’s 2012 Ethics Survey examined how more than 24,000 U.S. physicians would react when faced with a wide range of ethical dilemmas, including end-of-life care, physician performance, abortion, romantic relationships with patients, malpractice, insurance, and patient communications and consent.
“The increasing number of conflicting forces makes ethical decisions tougher and more wrenching for physicians,” said Leslie Kane, MA, executive editor of Medscape Business of Medicine. “Technological advances, new regulations, and more pressure to control costs all fight with the doctors’ desire to give patients the best possible care. Some ethical issues are life-and-death struggles, and doctors take them strongly to heart.”
With continuing technological advancements, compounded with mandates for the appropriate expenditure of resources, physicians are facing more ethical issues than in the past.
- Defensive Medicine: When asked if it is acceptable to perform “unnecessary” procedures because of malpractice concerns, 23% of physicians responded “yes”, 55% “no” and 22% said “it depends.”
- Cost Containment: When asked if a patient who is “nonadherent” or “overuses” resources should be dismissed, 32% responded “yes”, 33% said “no”, and 36% said “it depends.”
- Insurance: When asked if insurers should be dropped if they do not pay well, even if longtime patients must stop seeing them, 27% of physicians surveyed responded “yes,” 41% said “no”, and 33% said “it depends.”
Decisions about the legal and financial implications of recommended care were not the only contentious issues among physicians. End-of-life care, which has been a key ethical dilemma during recent years, also revealed a sharp divide among physicians:
- When asked if physician-assisted suicide should be allowed in some situations, 47% of physicians said “yes,” 40% said “no”, and 13% said “it depends.”
- When asked if they would give life-sustaining therapy if they believe it to be futile, 35% said “yes”, 24% said “no”, and 41% said “it depends.”
“Armed with technology that can keep many terminally ill patients alive for months and years, doctors today face an extremely complicated decision that is often compounded by the wishes of family members,” Kane said. “Despite the complexity of these dilemmas, our survey revealed that doctors feel a significant amount of compassion for their patients — even if that might lead them to consider actions that may risk their medical license.”
The Medscape 2012 Ethics Survey found that 12% of physicians said “yes” and 13% said “it depends” when asked if it is acceptable to overstate or falsify a patient’s condition when submitting claims or seeking prior authorization. The majority (75%) of responding physicians, however, said “no.”
To learn more about the Medscape 2012 Ethics Survey findings and qualitative physician responses, visit
http://www.medscape.com/features/slideshow/public/ethics2012.
For additional information on ethics within the business of medicine, visit http://www.medscape.com/resource/ethics.
