The reception and implementation of ethical guidelines of the Swiss Academy of Medical Sciences in medical and nursing practice

Abstract

Questions under study: We conducted a survey among Swiss health care professionals on the reception and implementation of a number of selected ethical guidelines of the Swiss Academy of Medical Sciences (SAMS). The following guidelines were chosen for evaluation: “Care of patients in the end of life”, “Palliative care”, “Borderline questions in intensive-care medicine” and “The determination of death in the context of organ transplantation”. Methods: Anonymous questionnaires were sent to 1933 physicians (general practitioners and internists) and nurses, randomly chosen from address lists of the relevant professional associations. We conducted a statistical analysis using SPSS 16.0. Results: The response rate was 43.1%. 16.3% of the responding physicians had never heard of the guidelines “Care of patients in the end of life”, 30.5% had already heard of them, 34.1% knew some of their contents and 19.1% were familiar with the complete content of the guidelines. 60.5% of those physicians and 56.0% of those nurses who had at least heard of these guidelines utilised them in clinical practice. The guidelines “Palliative care” and “Borderline questions in intensive- care medicine” yielded similar results. By contrast, only 0.5% of responding physicians reported never having heard of the guidelines “The determination of death in the context of organ transplantation”, 2.9% had already heard of them, 24.4% knew some of their contents and the vast majority of respondents (72.2%) considered themselves to be completely familiar with the guidelines. Conclusion: Knowledge of the evaluated guidelines is fairly widespread among Swiss GPs, internists and nurses. The guidelines are utilised in clinical practice by the majority of those care providers who are aware of their existence. The guidelines “The determination of death in the context of organ transplantation”, as a legally binding document, are even better known and routinely implemented in medical practice