Study On Professional Ethics Of Medical Personnel And Its Improvement Strategies

ObjectiveThis study is designed to find the problems in the practice of professional ethics of medical personnel through investigation of the current status of medical personnel's professional ethics. Patients'perception of professional ethics is analyzed and a comparison is made between medical personnel's perception and patients. These are all carried out with the aim to discuss the influencing factors of medical personnel's professional ethics. Based on this, the improvement strategies of professional ethics are discussed so as to provideContent and Methods(1) Literature analysis. Documents about medical personnel's professional ethics were collected to identify the connotation of medical personnel's professional ethics and the primary principles that should be followed in medical service delivery.(2) Field survey. 6 hospitals in Wuhan, Xiangyang and Zhuhai were sampled to carry out questionnaire investigation among the medical personnel and patients and individual in-depth interview. Through this survey, the current status of professional ethics and patients'perception were understood.(3) Quantitative analysis. Nonparametric test, Logistic Regression and descriptive analysis including Chi-square test and Fisher's test were used to analyze the current status of medical personnel's professional ethics, patients'perception and their difference.(4) Qualitative analysis. Fishbone diagram was used to carry out qualitative analysis of the influencing factors of medical personnel's professional ethics. Results(1) Domestic study mainly concentrated on the behavior standards of medical personnel, while foreign related study emphasized the right and duty of medical personnel and patients in treatment process. The basic principles of medical personnel's professional ethics were concluded as maximization of patients'benefit, informed consent, honesty and self-control based on literature analysis.(2) Quantitative analysis showed that the general situation of medical personnel's professional ethics practice was comparatively fine. 56.67% of the medical personnel could always treat patients equally and 76.92% of them insisted on explaining the side-effect to patients. However, there were still some problems, especially in the aspects of avoiding the use of academic words and initiative explanation of certain treatment plan.(3) There was significant difference in the behaviors of careful listen to patients'illness description and requirement of illness description repeat by patients among out-patient doctors, in-patient doctors and nurses.(4) Through quantitative analysis of patients'perception, 49.33% of the patients would not pay attention to medical personnel's behaviors, 67.11% of the patients had heard about under-the-table payment of patients for medical personnel and 33.33% of them had not heard about the patient's right of informed consent. Logistic Regression analysis showed that age and educational background influenced patients'knowledge on whether they had heard about patients'right of informed consent.(5) Qualitative analysis of the influencing factors of medical personnel's professional ethics reflected that professional ethics was influenced by various factors, which could be classified into professional factors, individual factors, organizational factors and social factors. Professional factors included professional risks, professional pressure and professional feature; individual factors included medical personnel's individual emotion, working field, gender, age and patients'expectation, classification, gender, educational background and income; organizational factors included rules and regulations, incentive mechanism and organization culture; social factors included media and social conduct. DiscussionsThrough quantitative and qualitative analysis, some problems were found: (1) Medical personnel were lacking of professional responsibility. Some of the medical personnel did not take patients seriously; (2) The professional location of medical personnel was deviated. Individual economic interest was put on the first place instead of patients'benefits; (3) There was a lack of medical humanistic care in treatment process. Patients were considered as combination of organs rather than individuals; (4) The practice situation of professional ethics of out-patient doctors, in-patient doctors and nurses differ from each other; (5) Patients did not have enough awareness of protecting their right of informed consent; (6) The mutual trust of medical personnel and patients was inadequate; (7) The personnel allocation was not reasonable; (8) The social welfare policy was not perfect; (9) The perception gap of professional ethics between medical personnel and patients was comparatively large; (10) Medical personnel's professional ethics was influenced by various factors.SuggestionsBased on the above analysis, some suggestions were proposed as the following: (1) Entry qualification evaluation system of medical students is expected to be established; (2) Enough attention should be paid to the training about professional ethics; (3) Rules and regulations about professional ethics standards should be well established with powerful supervision; (4) Reasonable payment and incentive mechanism should be made; (5) Activities for improving professional ethics status should be hold with positive media report; (6) Medical resources should be reasonably allocated; (7) The popularization of health related knowledge should be strengthened; (8) Hospital service brand is expected to be constructed.Innovations and LimitationsInnovations: This study has come up with some new suggestions: (1) Professional ethics standards should be made according to different working fields; (2) Entry qualification evaluation system of medical students is expected to be established; (3) Hospital should actively communicate with the media; (4) Hospital service brand is expected to be constructed.Limitations: As time and funding constraints, only 6 hospitals in Wuhan, Xiangyang and Zhuhai were sampled, and the results may be less representative. For the questionnaire survey of inpatients was conducted with the assistance of nurses, some data might not fully reflect the true thoughts of the patients.