Barr D A
Stanford University, California, USA.
J Med Ethics. 1996 Feb;22(1):33-40. doi: 10.1136/jme.22.1.33.
To study and report the attitudes and practices of physicians in a former Soviet republic regarding issues pertaining to patients' rights, physician negligence and the acceptance of gratuities from patients.
Survey questionnaire administered to physicians in 1991 at the time of the Soviet breakup.
Estonia, formerly a Soviet republic, now an independent state.
A stratified, random sample of 1,000 physicians, representing approximately 20 per cent of practicing physicians under the age of 65.
Most physicians shared information with patients about treatment risks and alternatives, with the exception of cancer patients: only a third of physicians tell the patient when cancer is suspected. Current practice at the time of the survey left patients few options when physician negligence occurred; most physicians feel that under a reformed system physician negligence should be handled within the local facility rather than by the government. It was common practice for physicians to receive gifts, tips, or preferential access to scarce consumer goods from their patients. Responses varied somewhat by facility and physician nationality.
The ethics of Soviet medical practice were different in a number of ways from generally accepted norms in Western countries. Physicians' attitudes about the need for ethical reform suggest that there will be movement in Estonia towards a system of medical ethics that more closely approximates those in the West.
研究并报告前苏联一个加盟共和国的医生在患者权利、医生过失以及接受患者馈赠等问题上的态度和行为。
1991年苏联解体时对医生进行问卷调查。
爱沙尼亚，曾是苏联加盟共和国，现独立国家。
1000名医生的分层随机样本，约占65岁以下执业医生的20%。
大多数医生会与患者分享治疗风险和其他选择，但癌症患者除外：只有三分之一的医生在怀疑患癌症时会告知患者。调查时的现行做法是，医生出现过失时患者几乎没有选择；大多数医生认为，在改革后的体系中，医生过失应由当地医疗机构而非政府处理。医生接受患者的礼物、小费或优先获得稀缺消费品是常见现象。不同医疗机构和医生国籍的回答略有差异。
苏联医疗行为的伦理在许多方面与西方国家普遍接受的规范不同。医生对伦理改革必要性的态度表明，爱沙尼亚将朝着更接近西方的医学伦理体系发展。
