Abstract

BackgroundThis article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work.MethodsThis study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.ResultsWe found that that molecular biologists consider the principle of respect for autonomy as a negative obligation, where the informed consent of patients or research subjects should be respected. Furthermore, molecular biologists believe that very sick patients are constraint by the circumstances to a certain choice. However, in contrast to molecular biologists, oncology physicians experience the principle of respect for autonomy as a positive obligation, where the physician in dialogue with the patient performs a medical prognosis based on the patient's wishes and ideas, mutual understanding and respect. Oncology physicians believe that they have a positive obligation to adjust to the level of the patient when providing information making sure that the patient understands. Oncology physicians experience situations where the principle of respect for autonomy does not apply because the patient is in a difficult situation.ConclusionIn this study we explore the moral views and attitudes of oncology physicians and molecular biologists and compare these views with bioethical theories of the American bioethicists Tom L. Beauchamp & James F. Childress and the Danish philosophers Jakob Rendtorff & Peter Kemp. This study shows that essential parts of the two bioethical theories are reflected in the daily work of Danish oncology physicians and Danish molecular biologists. However, the study also explores dimensions where the theories can be developed further to be concordant with biomedical practice. The hope is that this study enhances the understanding of the principle of respect for autonomy and the way it is practiced.

Highlights

  • This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work

  • Sample This study is based on 12 semi-structured interviews with three groups of respondents: a group of Danish oncology physicians working in a clinic at a public hospital and two groups of Danish molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company (Table 1)

  • If we turn to the themes of the structural analysis, generally we see that three of the five important meanings of autonomy that Rendtorff & Kemp put forward are reflected in the interviews: 1) The capacity for rational decision and action without coercion, 2) The capacity for giving informed consent to medical experiments and 3) The capacity for the creation of ideas and goals for life [12]

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Summary

Introduction

This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. The fact that molecular biologists investigate DNA and cells in cultures, whereas oncology physicians work with human beings in a doctor-patient relationship might have the effect that molecular biologists and oncology physicians perceive or experience the principle of respect for autonomy of the patient or the research subject in different ways During their daily work, molecular biologists conduct basic research, they do not perform animal testing or clinical trials. Findings from the larger research project show that in general, molecular biologists experience that in contrast to animal testing and clinical trials, basic research does not cause significant ethical problems as long as a signed informed consent sheet is available from the research subject or the patient They do face environmental risks regarding radioactivity and chemicals, but these are minimal. This article focus on how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work

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