Abstract
Our knowledge about ethical conflicts in primary care is limited. The aim of this study was to ascertain the frequency of ethical conflicts and the need of professional consultation services - seen from the perspective of general practitioners (GPs). A random sample of GPs from Lower Saxony, a federal state of Germany, received a standardized questionnaire about their experiences with ethical conflicts and their need for an ethical consultation. A total of 456 GPs took part in the survey (response rate = 45.6 %). Eighty percent experienced the conflict of a "withdrawal of medicines due to questionable benefit for the patient" once in 3 months, at least (95 % confidence interval: 76.0 to 83.6 %). Further frequent conflicts were "the continuation of a therapy of questionable benefit" (68 %; 63.3 to 72.0 %) and the "usefulness of diagnostic procedures for early detection of diseases and risk factors in seriously ill patients" (62 %; 57.7 to 66.8 %). About one-third (138/451) of the participants requested an ethical consultation. GPs frequently wished an ethical consultation by phone. Although GPs experienced several of the ethical conflicts frequently, only one-third requested an ethical consultation. Low threshold offers may be a way to make ethical consultations more attractive for GPs.
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