Chan Shun Pavilion, 11175 Campus Street, Loma Linda, CA 92350 USA.
J Med Ethics. 2011 Jun;37(6):333-8. doi: 10.1136/jme.2010.040683. Epub 2011 Feb 2.
Physicians face competing values of truth-telling and beneficence when deception may be employed in patient care. The purposes of this study were to assess resident physicians' attitudes towards lying, explore lie types and reported reasons for lying.
After obtaining institutional review board review (OSR# 58013) and receiving exempt status, posts written by Loma Linda University resident physicians in response to forum questions in required online courses were collected from 2002 to 2007. Responses were blinded and manually coded by two investigators using NVivo software. Qualitative and quantitative analyses of the data were performed with links to various attributes. A 95% binomial proportion CI was used to analyse the attribute data.
The study found that the majority of residents (90.3%) would disclose the truth about medical errors. Similarly, many residents (55.7%) would disclose the truth regarding unanticipated events, especially if the error was serious enough to result in a malpractice suit (74.7%). However, many residents (40.9%) would not reveal a near miss event because they believe it has no impact on patient health. Some residents (47.3%) would deceive the insurance company for additional patient benefits. Of those willing to lie, only a small group (4.2%) gave self-serving reasons.
This study demonstrates that the ethical issues related to deception that trouble attending physicians also exist at the resident physician level. Residents primarily lie for altruistic reasons and rarely for egoistic or self-serving purposes that may or may not result in harm to patients, insurance companies and/or physicians themselves.
当欺骗可能用于患者护理时，医生面临着说实话和行善的价值观冲突。本研究的目的是评估住院医师对说谎的态度，探讨说谎类型和报告说谎的原因。
在获得机构审查委员会审查（OSR#58013）并获得豁免地位后，从 2002 年至 2007 年，收集了洛马林达大学住院医师针对必修在线课程论坛问题所写的帖子。响应被两个调查员使用 NVivo 软件进行盲法和手动编码。使用链接到各种属性对数据进行定性和定量分析。使用 95%二项式比例置信区间分析属性数据。
研究发现，大多数住院医师（90.3%）会披露医疗错误的真相。同样，许多住院医师（55.7%）会披露意外事件的真相，尤其是如果错误严重到导致医疗事故诉讼（74.7%）。然而，许多住院医师（40.9%）不会透露接近失误事件，因为他们认为这对患者健康没有影响。一些住院医师（47.3%）会为了给患者争取额外的利益而欺骗保险公司。在那些愿意说谎的人中，只有一小部分（4.2%）给出了自私的理由。
这项研究表明，困扰主治医生的与欺骗有关的道德问题也存在于住院医师层面。住院医师主要出于利他主义的原因说谎，很少出于可能对患者、保险公司和/或医生自己造成伤害的自我主义或自私的目的说谎。
