Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic

Abstract Background During the COVID-19 pandemic, global healthcare systems faced unprecedented challenges, with a lack of resources and suboptimal patient care emerging as primary concerns. Methods Our research, using a comprehensive 24-item electronic questionnaire, “Reflections on the Provision o...

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Main Authors: Ilona Tietzova, Radka Buzgova, Ondrej Kopecky
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Medical Ethics
Online Access:https://doi.org/10.1186/s12910-024-01133-w
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author Ilona Tietzova
Radka Buzgova
Ondrej Kopecky
author_facet Ilona Tietzova
Radka Buzgova
Ondrej Kopecky
author_sort Ilona Tietzova
collection DOAJ
description Abstract Background During the COVID-19 pandemic, global healthcare systems faced unprecedented challenges, with a lack of resources and suboptimal patient care emerging as primary concerns. Methods Our research, using a comprehensive 24-item electronic questionnaire, “Reflections on the Provision of Healthcare during the COVID-19 Pandemic,” delved into the experiences of 938 physicians across the Czech Republic. Results Over fifty per cent observed a “lower standard of care” compared to pre-pandemic levels. A division arose among physicians regarding a decision’s medical, ethical, or legal basis, with a notable gender disparity: male doctors leaned towards medical perspectives, whereas females accented the ethical perspective. Decision-making concerning health care limitations required agreement among the physicians on duty, interdisciplinary teams, or shift supervisors. Physicians reported varying degrees of patient or family participation in health care decisions. Variables such as age, pre-existing health conditions, and life expectancy influenced care decisions. Surprisingly, half of the physicians faced refusals of patients’ transportation to better-equipped facilities due to resource constraints. One-third of physicians never discuss the decision about care limitation and other options with patients or their families. As a result, almost fifty per cent of the physicians rarely or never imparted information about care limitations to patients. Conclusion The survey shed light on the profound ethical dilemmas hospital physicians face across different types of healthcare facilities during the pandemic. It uncovered the need for open dialogue and scholarly debate on resource allocation and strengthening the role of patients and their families in care decisions in future healthcare crises.
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spelling doaj-art-96a4c9ef050a4442a9f73ac6d66d4c9f2024-12-08T12:45:29ZengBMCBMC Medical Ethics1472-69392024-12-0125111010.1186/s12910-024-01133-wDecision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech RepublicIlona Tietzova0Radka Buzgova1Ondrej Kopecky2First Department of Tuberculosis and Respiratory Diseases, First Faculty of Medicine, General University Hospital in Prague, Charles UniversityDepartment of Nursing and Midwifery, Faculty of Medicine, University of OstravaDepartment of Palliative Medicine, First Faculty of Medicine, General University Hospital in Prague, Charles UniversityAbstract Background During the COVID-19 pandemic, global healthcare systems faced unprecedented challenges, with a lack of resources and suboptimal patient care emerging as primary concerns. Methods Our research, using a comprehensive 24-item electronic questionnaire, “Reflections on the Provision of Healthcare during the COVID-19 Pandemic,” delved into the experiences of 938 physicians across the Czech Republic. Results Over fifty per cent observed a “lower standard of care” compared to pre-pandemic levels. A division arose among physicians regarding a decision’s medical, ethical, or legal basis, with a notable gender disparity: male doctors leaned towards medical perspectives, whereas females accented the ethical perspective. Decision-making concerning health care limitations required agreement among the physicians on duty, interdisciplinary teams, or shift supervisors. Physicians reported varying degrees of patient or family participation in health care decisions. Variables such as age, pre-existing health conditions, and life expectancy influenced care decisions. Surprisingly, half of the physicians faced refusals of patients’ transportation to better-equipped facilities due to resource constraints. One-third of physicians never discuss the decision about care limitation and other options with patients or their families. As a result, almost fifty per cent of the physicians rarely or never imparted information about care limitations to patients. Conclusion The survey shed light on the profound ethical dilemmas hospital physicians face across different types of healthcare facilities during the pandemic. It uncovered the need for open dialogue and scholarly debate on resource allocation and strengthening the role of patients and their families in care decisions in future healthcare crises.https://doi.org/10.1186/s12910-024-01133-w
spellingShingle Ilona Tietzova
Radka Buzgova
Ondrej Kopecky
Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic
BMC Medical Ethics
title Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic
title_full Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic
title_fullStr Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic
title_full_unstemmed Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic
title_short Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic
title_sort decision making and ethical dilemmas experienced by hospital physicians during the covid 19 pandemic in the czech republic
url https://doi.org/10.1186/s12910-024-01133-w
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AT ondrejkopecky decisionmakingandethicaldilemmasexperiencedbyhospitalphysiciansduringthecovid19pandemicintheczechrepublic