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Sede
Social
Colegio Oficial
de Médicos
de Barcelona
Paseo de la Bonanova, 47
08017 Barcelona
Telf.: 93 863 02 38
Fax: 93 863 05 58
secretariaseacv@telefonica.net |
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Lunes, 23 de Enero de 2012
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| Publicación
Española del Mes Nº 1 |
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Son las 01:26:59 horas del 5-2-2012 |
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Archivo PDF
(60 KB)
Clara A, Merino J, Mateos E, Ysa A, Roman B, Vidal-Barraquer
F, Vascuethics Study Group. The vascular surgeon facing
clinical ethical dilemmas (the VASCUETHICS Study): 'V'-shaped
association between compassionate attitudes and professional
seniority. Eur J Vasc Endovasc Surg. 2006;31:594-599.
Servicio de Angiología y Cirugía
Vascular, Hospital del Mar, Barcelona, España.
aclara@imas.imim.es.
Factor de impacto de Eur J Vasc Endovasc Surg
= 2.026 (nº 28 de las revistas sobre Cirugía,
según el Journal Citation Report).
OBJECTIVE: To evaluate the association
between compassionate attitudes and seniority in vascular
surgeons facing clinical ethical dilemmas (CED).
SUBJECTS AND METHODS: (1) Design: Cross-sectional.
(2) Subjects: Vascular surgeons (residents included) from
the 28 vascular teaching departments of one European country.
(3) Measurements: Multidisciplinary team-designed, structured
and self-administered questionnaire consisting of five
clinical ethical dilemmas, of which four had conflict
between compassion towards a 'small' or 'very costly'
beneficial action vs. a reasonable but more 'pragmatic'
allocation of health resources. Participants stated their
degree of agreement with eight answers representing the
two attitudes on a continuous scale. (4) Statistics: Cluster
analysis and logistic regression model adjusted by confounding
factors.
RESULTS: Two hundred and fifty three
vascular surgeons (median age 37 years, 74% male) from
the 26 participating teaching vascular departments (public
hospitals) completed the questionnaire (88% surgeons/department).
Cluster analysis identified two groups of surgeons according
to their pattern of answers: Group I (n=63) were mainly
compassionate whereas Group II (n=180) were mainly pragmatic.
The multivariate analysis disclosed, after adjusting for
additional private practice, on call services and career
status, a significant V-shaped relationship between the
compassionate behaviour and seniority. Surgeons with 8-15
years experience were the least compassionate.
CONCLUSIONS: The youngest and the most
senior vascular surgeons were more prone to favour compassionate
attitudes when facing clinical ethical dilemmas. Although
both compassionate and pragmatic attitudes may be legitimate
ethically, physicians not favouring compassion may be
at risk of leaving the patient without an advocate within
the health care system.
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