Conscientious objection in spanish podiatrists students: a questionnaire survey / Objeción de conciencia en estudiantes españoles de podología: estudio mediante cuestionario / Objeção de consciência em estudantes de podologia na Espanha: um questionário de sondagem

Objective: To explore attitudes towards conscientious objections among podiatrists students in Spain. Methods: Podiatrists students at University of A Coruña, King Rey Juan Carlos University, University of Sevilla and Complutense University of Madrid were emailed a link to complete an anonymous online questionnaire, hosted by an online survey company. A total of 432 podiatrists students responded. Results: Nearly half of the students in this survey stated that they believed in the right of podiatrist to conscientiously object to any procedure. Demand for the right to conscientiously object is greater in Roman Catholic podiatrists students when compared with other groups of religious podiatrists students. Discussion: Examining patients and podiatric treatments continues to be controversy issues among podiatrists students and this may contribute to the looming crisis in podiatry services over next years. This project sheds some light on how future podiatrist view some of their ethical rights and obligations. Using empirical evidence, it reveals that conscientious objection is an issue in the Spain podiatrists student body today. These data could help anticipate problems that may arise when these podiatrists students qualify and practice podiatry in the community. Conclusion: Clearer guidance is needed for podiatrists students about the issue of conscientious objection at podiatry school.

Objetivo: Explorar actitudes hacia la objeción de conciencia entre estudiantes de podología en España. Métodos: Se realizó un cuestionario anónimo online vía email a estudiantes de podología de la Universidad del Rey Juan Carlos de la Coruña, la Universidad de Sevilla y la Universidad Complutense de Madrid, organizado por una empresa de encuestas online. Respondieron un total de 432 estudiantes de podología. Resultados: Casi la mitad de los estudiantes afirmaron en la encuesta que creían en el derecho del podólogo a la objeción de conciencia en cualquier procedimiento. La exigencia del derecho a objeción de conciencia fue mayor en estudiantes de podología católicos que en otros grupos de otras religiones. Discusión: Examinar a pacientes y los tratamientos de podología continúan siendo temas controversiales entre los estudiantes de podología y esto puede que contribuya a la inminente crisis en servicios de pedicura en los próximos años. Este proyecto derrama algo de luz sobre como futuros podólogos ven algunos de sus derechos y obligaciones éticas. Usando evidencia científica, revela que la objeción de conciencia es un tema para los estudiantes de podología en España hoy día. Estos datos pueden ayudar a anticipar problemas que puedan surgir cuando estos estudiantes de podología califiquen y practiquen podología en la comunidad. Conclusión: Se necesitan pautas más claras para estudiantes de podología sobre el tema de objeción de conciencia en la Escuela de Podología.

Objetivo: Explorar atitudes com relação à objeção de consciência entre os estudantes de podologia na Espanha. Método: Aos estudantes de podologia da Universidade Universidade Rei Juan Carlos, de Corunha, da Universidade de Sevilla e da Universidade Complutense de Madri foram enviados por email um link para completar um questionário online anônimo, hospedado por uma empresa de pesquisa on-line. Um total de 432 alunos de podologia responderam. Resultados: Quase metade dos alunos nesta pesquisa afirmaram que acreditavam no direito de podólogo se opor conscientemente a qualquer procedimento. A demanda para o direito de se opor conscientemente é maior em estudantes católicos romanos, quando comparado com outros grupos religiosos de estudantes. Discussão: O exame de pacientes e tratamentos podiátricos continuam a ser problema de controvérsia entre os alunos de podologia e isso pode contribuir para a crise iminente nos serviços de podologia para os próximos anos. Este projeto lança alguma luz sobre a forma de o futuro podólogo conhecer alguns dos seus direitos e obrigações éticas. Usando a evidência empírica, revela que a objeção de consciência é um problema no corpo discente de podologia da Espanha, hoje. Estes dados poderiam ajudar a antecipar problemas que podem surgir quando esses estudantes de podología se qualificarem e praticarem a podologia na comunidade. Conclusão: Orientação mais esclarecida é necessária para alunos de podologia sobre a questão da objeção de consciência no curso de graduação.

[Interprofessional ethical shared values for an integral healthcare]. / Valores Éticos Interprofesionales Compartidos para una Asistencia Integral.

Healthcare today requires the rapport of diverse professionals to give a comprehensive response to the needs and requirements of the population's health. Codes of ethics are the normative expression of secular reflection on the ethical values of the professions. In this study we aim to identify ethical values shared by various professionals codes of conduct and propose a method for evaluating the ethical estimate. For this reason, we have reviewed codes of ethics of the medical, nursing, physiotherapy, podiatry and psychology professions, identifying 30 values. These values were classified into two groups, depending on if these are shared by the 5 professionals codes or not (VIP vs VP). In order to provide a method for estimating common values it has been designed a survey likert type. Is possible to conclude there are ethical formally shared values identifiable in professional codes of conduct and it is possible to measure the estimate of ethical values accepted by health professionals. This measurement can be an effective aid to apply management methods of human resources that make it possible to achieve the comprehensive assistance based on inter-professional teams.

Comparative analysis of moral distress and values of the work organization between American and Spanish podiatric physicians.

BACKGROUND: Moral distress is a stress symptom arising from situations that involve ethical dimensions where the health-care provider believes that he or she is unable to preserve all interests and values at stake. The aims of this study were to evaluate the impact of, and identify possible differences in, moral distress in podiatric physicians in the United States and Spain and to determine the ethical principles most closely related to moral distress. METHODS: A 2008 e-mail survey of 93 US podiatric physicians and 93 Spanish podiatric physicians (N = 186) presented statements about different ethical dilemmas, values, and goals in the workplace. RESULTS: Although moral distress is strongly present across the sample for all of the questions, the US sample shows higher levels of any kind of moral distress concerning questions about patients' treatment and economic constraints, overload of paperwork, and acting against one's conscience. In the US sample, 91.4% of physicians agreed mostly or completely with the statement that they often had to compromise their own values to cope with the demands of the workplace; 89.25% of US podiatric physicians indicated that their own professional values were congruent with the values of the organization; and a similar percentage (77.5%) reported a strong identification with the goals and framework of their work organization. The Spanish sample had similar results. CONCLUSIONS: The results underline the significance of moral distress for both samples, mainly related to time constraints and organizational aspects concerning patients and lack of resources.

Moral distress related to ethical dilemmas among Spanish podiatrists.

OBJECTIVES: To describe the distress experienced by Spanish podiatrists related to ethical dilemmas, organisational matters, and lack of resources. DESIGN: A 2008 email survey of a representative sample of 485 Spanish podiatrists presenting statements about different ethical dilemmas, values and goals at the workplace. RESULTS: The response rate was 44.8%. Of all the respondents, 57% described sometimes having to act against their own conscience as distressing. Time constraints is the main cause of moral distress (67%) and 58% of respondents said that they found it distressing that patients have long waits for treatment. Distress related to inadequate treatment due to economical constraints or ineffectiveness was described by 60% of the podiatrists. Another 51% reported that time spent on administration and documentation is distressing. Female doctors experienced more distress than their male colleagues. Last, 36% of respondents reported that their workplace lacked strategies for dealing with ethical dilemmas. CONCLUSION: These study results identify moral distress among Spanish podiatrists mainly related to time constraints, patient demands and lack of resources. Moral distress varies with sex and age. Organisational strategies such as moral deliberation and responsive evaluation offer the potential to address moral distress.

Informed consent and advance directives.

Contrary to popular belief, a patient's signature on a piece of paper does not constitute informed consent. This article describes the ethical framework of consent in the context of the larger process of informed decision making. The elements of informed consent are examined in practical terms. Common pitfalls are addressed, with strategies to help anticipate and resolve possible dilemmas. These important tools are integral to all levels of medical decision making, including those at the end of life.

Primer on medical professionalism.

Medicine as a profession depends on a unique social contract between the public and health-care professionals. We define professionalism in medicine, provide examples of challenges in professionalism relevant to podiatric medicine, and offer resources on ethics and professionalism in medicine. "Medical professionalism" is the set of attitudes, values, and conduct exhibited by medical providers resulting from placing patients' and society's interests above their own. The primacy of patient welfare has been at the core of a set of values held by medical professionals since the drafting of the Hippocratic Oath, and it remains at the center of medical professionalism today.