274 (Po) Practical Dilemmas In Family Practice And A Virtue- Based Ethic

Conference: 
Author(s): 
R. Ruiz Moral, J. Ramon Loayssa
Unidad Docente de Medicina de Familia, Facultad de Medicina de C¢rdoba, Nodo COGRAMA (redIAPP), Centro de Salud de Noa¡n, Spain
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BACKGROUND/AIM:
To identify and analyse the ethical issues hidden behind the general practitioners everyday clinical dilemmas
METHODS:
50 family physicians attending 5 workshops. Each workshop was structured for promoting personal reflection. Doctors were invited to: 1) identify the qualities of a good doctor. 2) bring every day clinical situations giving raise doubts in decisions making 3) identify the main dilemmas that the situations bring about and the decision eventually chosen 4) Considering the previously doctors values and qualities highlighted, to identify which of them prevailed and which were infringed.
RESULTS:
Doctors average of practice was 15 years, most of them were trainees. About 50 different qualities or values were detected as important for being a good doctor; these could be classified as (non exclusives categories) technical attributes (to know medicine, to be a good communicator), duties (to be just) qualities or virtues (patient, prudent). The conflictive everyday practice situations were classified as follows (in order of frequency): Problems related with Patients social, administrative or organisational demands; Inappropriate clinical requests; Social situations; Patients reluctant to medical interventions; Patient-family conflicts; the Health System Organization; Uncertainty, Public Health. Although doctors recognized tensions among ethical principles they identify more easily the values and virtues affected in the different situations and in the decisions they made.
CONCLUSIONS:
The general practitioners everyday clinical dilemmas are pointed out the importance in Primary Care of a virtue-based ethics approach over the principles-based approach.
Literature: 
274 (PO) PRACTICAL DILEMMAS IN FAMILY PRACTICE AND A VIRTUE- BASED ETHIC