Perceptions of ethical dilemmas and decision-making: A study of Chinese health care professionals.

摘要

Since 1978, China's economic structure has been changed dramatically from the planned economy into market economy and the Chinese society has undergone fundamental changes due to its large-scale social and economic reforms. In addition, along with the development of economy, Chinese people's standard of living and quality of health care have been improved greatly. As a result, these reforms have drastically affected China's medical system, and Chinese health care professionals are facing new ethical dilemmas and problems within the current social transition context. At the same time, traditional Chinese philosophy, in particular, Confucianism, continues to strongly influence Chinese patient and health care professional's way of living and thinking regarding the field of medicine and nursing.;There are three overarching findings throughout the focus group interviews and the analysis of five research themes. First, economic affordability determines the patients' treatment and affects their family's opinion of the treatment. Second, throughout the research themes, the analysis found that Confucianism and Confucian morality seemed to influence the participants' conduct and opinions. Physicians and nurses in the study also suggested that the behaviours of patients and their family were also influenced by traditional Confucian values. Finally, throughout the 237 recorded research statements, there was no apparent difference between the participating physicians and nurses and their views of ethical issues.;This study employs qualitative research methods to identify the major ethical problems that Chinese health care professionals have in their daily practice and the process of ethical decision-making they use to deal with ethical dilemmas. This research also conducts comparison between Chinese physicians and nurses to see whether there are differences in their ethical issues and the way they treat ethical concerns. Focus group interviews were conducted with physicians and nurses in two different hospitals in Shandong province in 2009. In total, there were four focus group sessions of 5-7 participants involved in each. Two interviews were conducted with physicians, and the other two involved nurses. There were 11 physicians and 13 nurses who attended the focus group conversations. Two hundred and thirty seven statements were recorded in the focus group discussions. Throughout the data and transcriptions of the four interviews, there emerged five main research themes: economic issues, family issues, cultural influences, process of ethical decision-making, and the ethical education.