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Ethical conflicts develop during hospital emergency care

Lucas Imbernón FJ, Galán Traba MA, Roldán Ortega R

Servicio de Urgencias. Hospital General Universitario de Albacete. Complejo Hospitalario Universitario de Albacete, Spain. Servicio de Urgencias Hospital de Hellín. Albacete, Spain.

Objective: To detect the presence of ethical conflicts arising in the course of care given
by the staff of emergency departments and to identify the most common conflicts faced.
Methods: Cross-sectional, descriptive study of bioethical issues facing physicians and
nurses and other health care staff of hospital emergency departments within the Health
Care Area of Albacete, by means of a 34-item specific questionnaire applying the
language of ethical principles.
Results: Ethical conflicts arise at work with 'some frequency' according to 66
respondents (57.9%); 85 respondents (75.2%) reported that they resolve the conflicts
with the help of a colleague. Ninety-three (81.6%) reported never having received
training in bioethics. The conflicts the respondents face most often involve end of life
(43.9%) and patient confidentiality (36.0%). Most respondents (76.8%) stated that
patients should be fully informed about the care process in order to safeguard
compliance with the principle of voluntary informed consent.
Conclusions: Bioethics should form part of the continuous professional development of
emergency health care professionals, who must often cope with ethical issues, which
they resolve by talking them over with a colleague. Clinical ethics committees should
develop models for resolving ethical problems that develop in the emergency setting,
specifically those that affect end of life and patient confidentiality.

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