Perception of Physicians and Medical Students on common Ethical Dilemmas in a Pakistani Medical Institute

Knowledge about medical ethics is limited in Pakistan. The teaching of ethics in both under and postgraduate education is generally not formal. The aim of the survey was to assess the knowledge, attitudes and practices among the medical professionals in relation to medical ethics in an attempt to identify the medical ethics learning needs of Pakistani doctors. A self-administered structured questionnaire about knowledge, attitudes and practices regarding some common bioethical issues was devised and distributed among medical students and doctors attending a one day medical ethics workshop held at Shifa College of Medicine. The issues included clinical rationing of care, abortion, medical futility, and conflict of interest A total of 110 medical personnel completed the survey. There were 34 physicians with postgraduate diploma, 48 physicians who were either trainees or did not have any postgraduate qualifications, and 28 medical students. There were 56 males and 57 females. The mean age of respondents was 32±12 years. Most doctors disagreed to deprive elderly with expensive technologies. 91 % agreed for legal abortion where congenital defects or mother’s life is in jeopardy. There was a strong perception for not allowing parents to discontinue medical treatment in infants with severe physical or mental impairment. Similar pattern of disagreement was observed in elderly with terminal disease, vegetative sate or at risk of severe physical or mental impairment. 95 % agreed to disclose errors during surgical procedures to the patient. There seems to be strong element of beneficence in the perceptions of the physicians while making decisions in ethical dilemmas. Physicians also had trouble accepting discontinuation of medical treatment in infants with severe physical or mental impairment or elderly at risk due to terminal disease or vegetative state