Awareness about Knowledge, Attitude and Practice of Medical Ethics pertaining to Patient Care, among Male and Female Physicians Working in a Public Sector Hospital of Karachi, Pakistan - A Cross-Sectional Survey

Abstract

The aim of the study is to assess the knowledge, attitudes and practices of medical ethics among male and female healthcare professionals in a public sector hospital in Karachi, Pakistan. A structured questionnaire about knowledge of medical ethics and its role in the everyday decision making in the hospital was developed, tested and distributed among residents, consultant physicians at the Abbasi Shaheed Hospital, a tertiary care teaching hospital, during June and August 2016. The paper analyzed 70 responses from doctors at various level of training comprising residents and consultants. Each question had sub parts and hence was scored accordingly. The participants encountered ethical decision making situations in a diverse regularity, varying from ‘daily’ to ‘annually’. Interestingly, 9% of the doctors were not aware of the primary contents of the Hippocratic Oath, and 89% of these were junior doctors. Details of Nuremberg Code and Helsinki Code were known only to 4% of the total sample. Female physicians had a stronger opinion as compared to male physicians regarding practice of ethics. This included topics such as complying with the consent for procedures, treating violent/non-compliant patients, listening to the patient’s wishes, autonomy and above all the attribute of maintaining confidentiality. A significant difference in the level of knowledge between diverse cadres of physicians was noted. Physicians who had cleared their qualifying and/or licensing exams exams in first attempt scored higher than those who did not. The female participants have 1.65 times the odds of having a higher knowledge about medical ethics, than male participants, keeping all other variables constant. The study highlights the need to strengthen the professional knowledge regarding medical ethics issues, among the health care workforce in public sector hospitals of the developing world. In our data, female physicians working in the government sector hospitals in Karachi, demonstrate a higher knowledge about medical ethics, than male participants, keeping all other variables constant.