Postgraduate Program in Medical Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
BMC Med Ethics. 2012 Mar 16;13:2. doi: 10.1186/1472-6939-13-2.
Pediatrics ethics education should enhance medical students' skills to deal with ethical problems that may arise in the different settings of care. This study aimed to analyze the ethical problems experienced by physicians who have medical education and pediatric care responsibilities, and if those problems are associated to their workplace, medical specialty and area of clinical practice.
A self-applied semi-structured questionnaire was answered by 88 physicians with teaching and pediatric care responsibilities. Content analysis was performed to analyze the qualitative data. Poisson regression was used to explore the association of the categories of ethical problems reported with workplace and professional specialty and activity.
210 ethical problems were reported, grouped into five areas: physician-patient relationship, end-of-life care, health professional conducts, socioeconomic issues and health policies, and pediatric teaching. Doctors who worked in hospitals as well as general and subspecialist pediatricians reported fewer ethical problems related to socioeconomic issues and health policies than those who worked in Basic Health Units and who were family doctors.
Some ethical problems are specific to certain settings: those related to end-of-life care are more frequent in the hospital settings and those associated with socioeconomic issues and public health policies are more frequent in Basic Health Units. Other problems are present in all the setting of pediatric care and learning and include ethical problems related to physician-patient relationship, health professional conducts and the pediatric education process. These findings should be taken into consideration when planning the teaching of ethics in pediatrics.
This research article didn't reports the results of a controlled health care intervention. The study project was approved by the Institutional Ethical Review Committee (Report CEP-HIJG 032/2008).
儿科学伦理学教育应增强医学生应对可能在不同医疗环境中出现的伦理问题的技能。本研究旨在分析具有医学教育和儿科医疗责任的医生所经历的伦理问题，以及这些问题是否与他们的工作场所、医学专业和临床实践领域相关。
88 名具有教学和儿科医疗责任的医生自行回答了一份半结构化的调查问卷。采用内容分析法对定性数据进行分析。采用泊松回归分析报告的伦理问题类别与工作场所和专业专业及活动的关联。
报告了 210 个伦理问题，分为五个领域：医患关系、临终关怀、卫生专业人员行为、社会经济问题和卫生政策以及儿科教学。在医院工作的医生以及普通和专科儿科医生报告的与社会经济问题和卫生政策相关的伦理问题少于在基本卫生单位工作的家庭医生。
一些伦理问题与特定环境有关：与临终关怀相关的问题在医院环境中更为常见，与社会经济问题和公共卫生政策相关的问题在基本卫生单位中更为常见。其他问题存在于儿科医疗和学习的所有环境中，包括与医患关系、卫生专业人员行为和儿科教育过程相关的伦理问题。在规划儿科学伦理学教学时，应考虑这些发现。
本研究报告未报告对照卫生保健干预的结果。该研究项目得到了机构伦理审查委员会的批准（报告 CEP-HIJG 032/2008）。
