therefore, the purpose of this study was to identify the top ethical challenges facing patients and families in health care, from the perspective of a panel of clinical bioethicsts. the justification for using a panel of bioethicists rather than a panel of community members is that clinical bioethicists will have a greater familiarity with the overall range of challenges than community members due to the fact that the ethical challenges are highly concentrated in their day-to-day work. with a total of 113 out of a possible 120 points, the highest ranked ethical challenges facing the public in health care was disagreement between patients/families and health care providers over treatment decisions. seventh on the list according to the panel was the challenge of obtaining informed consent in the health care setting. this is a challenge that patients and families will only face indirectly, as the general public is likely unaware of what the issues are related to surgical innovation. interviewed a group of physicians and nurses to elicit their perception of “ethics problems” in the care of their patients [7].
it is not surprising, however, that a panel of clinical bioethicists ranked disagreements between patients/families and health care professionals over treatment decisions as the top ethical challenge facing the public in health care. compared to the attention given to many of the challenges listed in the top ten, it is remarkable how little attention has been given to the top challenge. thus, although the panel was asked to report on the top ethical challenges facing canadians in health care, we believe the results of this study would be of interest to other countries. rather, the purpose was to identify what those top ten challenges are from the perspective of a group of highly qualified and experienced clinical bioethicists who work in a variety of health care institutions. 1999, institute of medicine, committee on quality of health care in america: flory j, emanuel e: interventions to improve research participants’ understanding in informed consent for research: a systematic review. grant support: dr. singer is supported in part by a distinguished investigator award from the canadian institutes of health research.
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