ABSTRACT Ethics is the “study of morality – careful and systematic analysis of moral decisions and behaviors and practicing those decisions”. The four ethical principles form the basis of ethical medical practice, namely, autonomy, justice, beneficence, and non-maleficence. A descriptive cross-sectional study was done among 120 specialist medical officers in four selected allopathic healthcare institutions in Sri Lanka, using a pretested validated self-administered questionnaire in 2021 to describe their knowledge, attitudes and practices related to medical ethics. The response rate was 90.00%(n=108). When considering the knowledge and attitudes related to medical ethics it was found that the majority(n=64,59.30%) of the specialist medical officers strongly disagree that “confidentiality is not so important aspect of treatment”. Among the total respondents 26(24.10%) strongly agree and 54 respondents (50%) agree with statement “close relatives should be told about patients condition”. When considering the practices related to medical ethics, we found that “ if a patient wishes to die, he or she should be assisted in doing so no matter what their illness” is  the ethical practice to which 32(29.60%) respondents  strongly disagree with and 56(51.90%) disagree with. We further discovered that 48(44.40%) of the respondents strongly agree and 52(48.10%) agree with the practice “ethics as a part of syllabus should be taught in every medical teaching institution”. These findings imply that Sri Lankan specialist doctors have a sound knowledge and positive attitudes towards the basic ethical principles. But they still need to improve their knowledge and attitudes related to ethical issues regarding their own colleagues. Continuous medical education for specialist medical officers, establishing ethics committees in hospitals, appointing ethicists to hospitals and conducting clinical case conferences regarding unethical practice are recommended to improve the situation.    RESUMEN  La ética es el "estudio de la moralidad, es decir, el análisis cuidadoso y sistemático de las decisiones y comportamientos morales y la práctica de esas decisiones". Los cuatro principios éticos constituyen la base de la práctica médica ética, a saber, la autonomía, la justicia, la beneficencia y la no maleficencia. Se realizó un estudio transversal descriptivo entre 120 médicos especialistas de cuatro instituciones sanitarias alopáticas seleccionadas en Sri Lanka, utilizando un cuestionario autoadministrado validado previamente en 2021 para describir sus conocimientos, actitudes y prácticas relacionadas con la ética médica. La tasa de respuesta fue del 90,00% (n=108). Al considerar los conocimientos y las actitudes relacionados con la ética médica, se descubrió que la mayoría (n=64, 59,30%) de los médicos especialistas están muy en desacuerdo con que "la confidencialidad no es un aspecto tan importante del tratamiento". Del total de encuestados, 26 (24,10%) están muy de acuerdo y 54 (50%) están de acuerdo con la afirmación "se debe informar a los familiares cercanos sobre el estado del paciente". Al considerar las prácticas relacionadas con la ética médica, descubrimos que "si un paciente desea morir, se le debe ayudar a hacerlo sin importar su enfermedad" es la práctica ética con la que 32 (29,60%) encuestados están muy en desacuerdo y 56 (51,90%) están en desacuerdo. Además, descubrimos que 48 (44,40%) de los encuestados están muy de acuerdo y 52 (48,10%) están de acuerdo con la práctica "la ética como parte del programa de estudios debería enseñarse en todas las instituciones de enseñanza médica". Estos resultados implican que los médicos especialistas de Sri Lanka tienen un buen conocimiento y actitudes positivas hacia los principios éticos básicos. Sin embargo, todavía necesitan mejorar sus conocimientos y actitudes en relación con las cuestiones éticas de sus propios colegas. Para mejorar la situación, se recomienda la formación médica continua de los médicos especialistas, la creación de comités de ética en los hospitales, el nombramiento de especialistas en ética en los hospitales y la realización de conferencias sobre casos clínicos relacionados con prácticas no éticas. 

The safety climate is “the summary of molar perceptions that employees share about their work environments” and associated with several factors. A descriptive cross-sectional study was done among a randomly selected sample of medical officers (n= 109) and nursing officers (n=193) to evaluate the safety climate and its associated factors in Base Hospital Avissawella Sri Lanka. Among the six safety climate dimensions personal protective and engineering control equipment availability (mean=3.94, SD=0.67) was perceived at the highest level. The lowest scored perceptual dimension was absence of job hindrances (mean=3.27, SD=0.83).  Among the respondents 219 (83.5%) had at least one exposure incident. There is no significant relationship between job category and workplace exposure incidents (p= 0.388).  Only 28.3% (n=62) had reported about their injuries. Only 60.7% (n=159) were strictly compliant to safe work practices and the compliance of nursing officers was better than of medical officers (p=0.000). The safety climate had a negative association with workplace exposure incidents (OR< 1.0) and a positive association with compliance to safe work practices. (OR>1.0). The respondents had negative perceptions about some of the safety climate dimensions.  Workplace exposure incidents were common and the reporting behavior about injuries was poor among both categories of staff, but comparatively the nursing officers were better. Majority were “Strict compliant” to the safe work practices and compliance was better among nursing officers. Safety climate was negatively associated with exposure incidents and positively with the compliance. The hospital managers should pay more attention on safety of employees, provide adequate training opportunities on occupational safety and encourage employees’ reporting behavior.

Results 92 feedback forms were returned (20 [22%] from the hub and 72 [78%] from four spokes). 4 (5%) males: 86 (96%) females, median age 30 years (range 16-64). Knowledge of services offered improved from median 4/10 (range 1-10/10) to median 10/10 (range 1-10/10) after reading the leaflet. 33/66 (50%) patients not originally attending for an STI screen would consider or agree to screening after reading the leaflet (36/82 [44%] for HIV testing respectively). The leaflet received an overall rating of median 10/10 (range 5-10/10). Discussion/conclusion Overall the leaflet was well received and improved patient's knowledge of services offered, and uptake of STI/HIV testing. Females provided the majority of feedback most likely due to spokes previously providing primarily contraceptive services. More work needs to be done to encourage males to attend the spoke clinics.