Chiu Priscilla P L, Hilliard Robert I, Azzie Georges, Fecteau Annie
Division of General Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada M5G 1X8.
J Pediatr Surg. 2008 Jun;43(6):986-93. doi: 10.1016/j.jpedsurg.2008.02.016.
The aim of this study was to identify and qualify the ethical dilemmas faced by pediatric surgery trainees.
An online survey was sent to pediatric surgery trainees graduating between 2005 and 2008. Consent was obtained, and study investigators were blinded to the identity of the respondents during data analysis.
Of the 40 respondents, only 59% felt they had received adequate training in bioethics to handle ethical issues pertaining to the care of critically ill children. Although 83% of respondents routinely participated in palliative care discussions, 30% of respondents desired to have more opportunities to discuss end-of-life issues with their staff. Moral conflicts were resolved through direct discussions with the medical staff, family, or friends. Despite the presence and awareness of institutional policies on ethical behavior, 58% of respondents did not believe that ethical conflicts were resolved as a result of these policies, whereas 31% of respondents felt that reporting of unethical conduct would result in personal reprisals.
Pediatric surgery trainees face ethical and moral conflicts, but some are fearful of reprisals if these concerns are reported. A neutral forum to raise such issues may facilitate open discussions and eventual resolution of these conflicts.
本研究旨在识别并界定小儿外科实习医生所面临的伦理困境。
向2005年至2008年间毕业的小儿外科实习医生发送了一份在线调查问卷。获得了同意，并且在数据分析期间研究调查人员对受访者的身份保密。
在40名受访者中，只有59%的人认为他们在生物伦理学方面接受了足够的培训，以处理与重症儿童护理相关的伦理问题。尽管83%的受访者经常参与姑息治疗讨论，但30%的受访者希望有更多机会与他们的工作人员讨论临终问题。道德冲突通过与医务人员、家人或朋友的直接讨论得以解决。尽管存在关于道德行为的机构政策并对其有所认识，但58%的受访者不认为这些政策能解决伦理冲突，而31%的受访者认为举报不道德行为会导致个人遭到报复。
小儿外科实习医生面临伦理和道德冲突，但有些人担心如果举报这些问题会遭到报复。一个提出此类问题的中立论坛可能有助于进行公开讨论并最终解决这些冲突。
