Survey Finds Physicians Divided on Ethical Issues

Laird Harrison

November 11, 2010

November 11, 2010 — Fewer than half of physicians think they should refuse gifts from drug companies, a Medscape survey on medical ethics has found.

Tallying up responses from more than 10,000 physicians to its August 2010 survey, Medscape also found the physicians sharply divided on such issues as physician-assisted suicide and life support.

"What came through loud and clear through this survey is that by and large, doctors try to do what they believe is right," Steven Zatz, MD, executive vice president of WebMD Professional Services, Medscape's parent company, said in a press release. "However, the results also highlight the complex ethical issues confronting physicians and their efforts to make appropriate decisions."

One of the most controversial of the 21 questions on the survey was, "Would you agree that you should refuse gifts or perks from pharmaceutical companies because they may influence your medical judgment?"

Almost 47% agreed and 37% disagreed, with the remaining 16% responding, "It depends." Several of those who provided written comments bristled at the suggestion that their decisions could be bought. "Post-It notes and pens do not influence my medical judgment," wrote one.

Physician-assisted suicide split the respondents even more sharply, with almost 46% in favor, 41% against, and the rest uncommitted. Comments ranged from "Assisted suicide is murder," to "I'd want it for me when the need arises."

Asked "Would you ever recommend or give life-sustaining therapy when you judged that it was futile?" the respondents also divided fairly evenly, with almost 24% marking "Yes," 37% marking "No," and 39% indicating "It depends."

Illustrating the complexity of the issue, 1 physician wrote about a patient who wanted to live to see his granddaughter. "I prolonged his intravenous therapy for 3 days until she arrived," he wrote. "He died the same night."

Among the other results:

  • 61% said it was not acceptable to perform a procedure merely to reduce the risk for a lawsuit, and 16% percent said it was;

  • 60% said it was not acceptable to hide a harmless mistake, and 19% said it was acceptable;

  • 58% would never prescribe a placebo just because a patient wanted treatment, and 24% would;

  • 73% said it is never acceptable to falsify a patient's condition when submitting claims, and 17% said falsification is acceptable "to get a patient the services."

The survey was conducted for a special series Medscape is publishing about medical ethics. Other articles will feature bioethics experts weighing in on why physicians answered the way that they did and what this means for the future of medicine.

"Today's doctors face more frequent and more complex bioethical dilemmas than in former times," Thomas H. Murray, PhD, president of the Hastings Center, a bioethical research institute in Garrison, New York, said in the press release. "If a physician recognizes that he or she is having a tough ethical dilemma, it shows that this is a morally conscious individual trying to do the right thing."

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