Perceived Difficulties in Managing Ethical Problems in Family Practice in Slovenia: Cross-sectional Study

Aim To determine the prevalence of difficulties in managing ethical dilemmas in family practice. Methods The study included a random sample of 259 family medicine physicians, representing 30% of the population of family physicians in Slovenia. Participants were given a self-administered questionnaire on perceived ethical dilemmas in their practice, with responses on a 5-point scale and a maximum score of 100. The main outcome measure was the percentage of family physicians reporting difficulties in solving perceived ethical dilemmas. Results The response rate was 55%. Physicians reported having difficulties in solving ethical dilemmas often or very often (mean score +/- standard deviation, 56.1 +/- 12.1). The most difficult ethical issue included abandoned and unattended patients and patients with insufficient means of support (48.6%), followed by suspicion of physical abuse, sexual abuse, or other criminal behavior (40.9%), and use of limited health care resources (21.1%). Female physicians reported greater difficulties in solving ethical dilemmas than male physicians (57.7 +/- 10.6 vs 53.0 +/- 14.1, P = 0.036, t test). Older physicians solved ethical issues more easily than younger ones (53.9 +/- 12.6 vs 58.2 +/- 11.2, P = 0.043, t test). Specialists and residents in family medicine considered solving ethical dilemmas to be more difficult than general practitioners without specialization (57.3 +/- 11.6 vs 47.1 +/- 11.8, P = 0.001, t test). Multivariate regression analysis of physician and practice characteristics did not yield any significant model to explain the differences in the perceived level of difficulties in solving ethical dilemmas. Conclusion Although managing ethical dilemmas is an important part of daily work of family physicians in Slovenia, it is perceived as a considerable burden in their work. Family physicians need more training in addressing and managing ethical issues.