Potential sources of conflict in intensive care units - a questionnaire study.

BACKGROUND: Conflicts occur in intensive care units (ICUs), and an international multicentre study conducted in 2008, including 323 ICUs from 24 European countries, confirmed the occurrence of this phenomenon. There are no data in Poland. The aim of the study was to analyse the frequency of the occurrence of conflicts in ICUs in Polish hospitals, and their most frequent sources. METHODS: The study was based on an original questionnaire performed in 12 ICUs in the Pomeranian Voivodship. The respondents were asked questions regarding the frequency, type, and lines of conflicts between employees, as well as potential causes of conflicts. RESULTS: Completed surveys were received from 232 employees, including 79 doctors and 153 nurses. The phenomenon of occurrence of conflicts was confirmed by about 30% of the staff, providing answer that conflicts occur "often". About 43% of staff estimated that conflicts "sometimes" occur and 25% chose the answer "rarely". Analysis of the answers made it possible to identify the most common potential causes of conflict. CONCLUSIONS: The main sources of conflicts in ICUs appear to be external factors such a financial issues and physical overload. The hospital policy and the health policy of the state are also important. The perceived conflicts require careful and constant monitoring. The frequency of hidden conflicts requires thorough assessment of their impact on the quality of work.

[The issue of autonomy in medical ethics: philosophy of Karol Wojtyla]. / Kwestia autonomii w etyce medycznej: filozofia Karola wojtyly.

The issue of autonomy seems to play a very central and fundamental role in contemporary medical ethics. However, it should be emphasized, that there is no agreement on how the concept of autonomy ought to be understood. Although as the main intellectual framework to describe the meaning of "autonomy" is the use of philosophical system of John St. Mill or Immanuel Kant, one could identify the tendency to redefine the concept under study. The aim of this article was to find out if the philosophy of Karol Wojtyla could provide--interesting from the bioethical point of view--insights into understanding of the idea of autonomy. The Wojtyla's critique of Kant's and Mill's understanding of autonomy was shortly described and the main elements of Wojtyla's concept of autonomy were analyzed. On the basis of these considerations it was assumed that philosophical background of Wojtyla is so different from those which are used in the contemporary, especially so called Anglo-American, bioethics that introducing it "elements" of his thinking would lead to misunderstandings and indeed even serious errors. On the other hand, however, philosophical works of Wojtyla seems to be very influential in developing 'personalistic' bioethics. But this bioethics could be accepted only by people who share Wojtyla's ontological and probably also theological or religious assumptions.