Does teaching medical ethics ensure good knowledge, attitude, and reported practice? An ethical vignette-based cross-sectional survey among doctors in a tertiary teaching hospital in Nepal

Abstract

Background Importance of awareness of medical ethics and its integration into medical curriculum has been frequently highlighted. Study 1 aimed to assess the knowledge, attitude, and reported practices of medical ethics among clinicians at Patan Academy of Health Sciences, a tertiary care teaching hospital in Nepal. Study 2 was conducted to assess whether there was a difference in knowledge, attitude, and reported practices of medical ethics among doctors who received formal medical ethics education during undergraduate studies and those who did not. Methods Two cross-sectional surveys using self-administered questionnaires were conducted. Study 1 included 72 participants; interns, medical officers, and consultants working at Patan Academy of Health Sciences. Study 2 was a comparative study conducted among 54 medical officers who had received formal medical ethics education (Group 1) and 60 medical officers who did not (Group 2). Results Participants who had completed post-graduate education had higher knowledge (p = 0.050), practice (p < 0.001), and overall combined scores (p = 0.011). Participants with ethics education had higher knowledge (p < 0.001), attitude (p = 0.001), practice (p < 0.001), and overall score (p < 0.001). Most participants preferred consulting colleagues if an ethical dilemma arose. Fewer participants had heard of the Declaration of Helsinki. Most participants thought doctors to be most capable of judging what is best for the patient (Study 1: 70.42%, Study 2 Group 1: 42.59%, Group 2: 80%). Case scenarios in which participants demonstrated poor practice were ethical issues concerning truth-telling, end-of-life decisions, treating HIV/AIDS patients, treating a minor, and reporting colleague’s errors. Conclusions This study found that participants who have received medical ethics education have higher knowledge, attitude, and practice scores. The results further justify the need for medical ethics education to be a part of the core medical curriculum. A blame-free environment where seniors can be approached for advice should be created. Research ethics should also be given attention. During medical ethics training, ethical issues where doctors perform poorly should be given more priority and should be discussed in a country-specific context.

Clinical Ethics, Knowledge, Attitudes and Practices of Nurses: A Limited Study in Turkey

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“…Clinical ethics deals with the professional behavior, duties and responsibilities of health professionals. 1 A n understanding of clinical ethics helps to anticipate, cope with and resolve ethical dilemmas that may be encountered in daily practice. Nurses have many ethical obligations to patients during clinical practice.…”

Knowledge, Attitude and Practice of Medical Ethics among Doctors and Nurses in Pokhara Valley, Nepal

“…Shrestha et al in her study had shown that participants who had received medical ethics education had higher knowledge, attitude, and practice scores. 18 Monsudi et al and Imran et al argued that different intensity of professional training creates the difference in opinions among health staffs. 19,20 The disparity seen in our study can be overcomed by standardization and uniformity in medical ethics related teaching curriculum in the undergraduate levels.…”