Decision-making and ethical dilemmas experienced by hospital physicians during the COVID-19 pandemic in the Czech Republic.

Publication date: Dec 04, 2024

During the COVID-19 pandemic, global healthcare systems faced unprecedented challenges, with a lack of resources and suboptimal patient care emerging as primary concerns. Our research, using a comprehensive 24-item electronic questionnaire, “Reflections on the Provision of Healthcare during the COVID-19 Pandemic,” delved into the experiences of 938 physicians across the Czech Republic. Over fifty per cent observed a “lower standard of care” compared to pre-pandemic levels. A division arose among physicians regarding a decision’s medical, ethical, or legal basis, with a notable gender disparity: male doctors leaned towards medical perspectives, whereas females accented the ethical perspective. Decision-making concerning health care limitations required agreement among the physicians on duty, interdisciplinary teams, or shift supervisors. Physicians reported varying degrees of patient or family participation in health care decisions. Variables such as age, pre-existing health conditions, and life expectancy influenced care decisions. Surprisingly, half of the physicians faced refusals of patients’ transportation to better-equipped facilities due to resource constraints. One-third of physicians never discuss the decision about care limitation and other options with patients or their families. As a result, almost fifty per cent of the physicians rarely or never imparted information about care limitations to patients. The survey shed light on the profound ethical dilemmas hospital physicians face across different types of healthcare facilities during the pandemic. It uncovered the need for open dialogue and scholarly debate on resource allocation and strengthening the role of patients and their families in care decisions in future healthcare crises.

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Concepts Keywords
Czech Adult
Global Clinical Decision-Making
Pandemic COVID-19
Physicians Czech Republic
Rarely Decision Making
Ethics, Medical
Female
Humans
Male
Middle Aged
Pandemics
Physicians
SARS-CoV-2
Surveys and Questionnaires

Semantics

Type Source Name
disease MESH COVID-19 pandemic
drug DRUGBANK Tropicamide
disease IDO role
pathway REACTOME Reproduction
disease MESH Tuberculosis
pathway KEGG Tuberculosis
disease MESH Respiratory Diseases
disease MESH infection
disease MESH tic
disease IDO facility
drug DRUGBANK Coenzyme M
disease IDO process
disease MESH malignancy
disease MESH obesity
drug DRUGBANK Trestolone
disease MESH end of life
disease MESH emotional distress
drug DRUGBANK Ethionamide
disease MESH anxiety
drug DRUGBANK Albendazole
drug DRUGBANK Lauric Acid
disease MESH chronic diseases
disease MESH Emergency

Original Article

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