Clinical Ethics Consultations are an important tool for physicians in solving difficult cases. They are extremely common in North America and to a lesser extent also present in Europe. However, there is little data on this practice in Poland. We present results of a survey of 521 physicians practising in Poland concerning their opinion on CECs and related practices. We analysed the data looking at such issues as CECs’ perceived availability, use of CECs, and perceived usefulness of such support. Physicians (...) in our study generally encounter hard ethics cases, even—surprisingly—those who do not work in hospitals. Most physicians have no CEC access, and those that do still do not employ CECs. However, physicians perceive this form of support as useful—even more so among actual users of CECs. We compared these findings with similar studies from other European countries and the North America. We point out peculiarities of our results as compared to those in other countries, with some possible explanations. We hope the results may encourage regulatory debate on the need to formally introduce CECs into the Polish healthcare system. (shrink)

The paper reports results of the very first survey-based study on the prevalence, frequency and nature of ethical or other non-medical difficulties faced by Polish physicians in their everyday clinical practice. The study involved 521 physicians of various medical specialties, practicing mainly in inpatient healthcare. The study showed that the majority of Polish physicians encounter ethical and other non-medical difficulties in making clinical decisions. However, they confront such difficulties less frequently than their foreign peers. Moreover, Polish doctors indicate different circumstances (...) as a source of the experienced problems. The difficulties most often reported relate to (i) patients (or their proxies) requests for medically non-indicated interventions; (ii) problems with communication with patients (or their proxies) due to the patients’ negative attitude, unwillingness to cooperate, or aggression; and (iii) various difficulties with obtaining informed consent. Polish physicians report difficulties associated with disagreements among care givers or scarcity of resources less frequently than doctors from other countries. The study’s findings provide support for the thesis that a significant portion of Polish physicians still follow a traditional, paternalistic, and hierarchical model of healthcare practice. Instead of promoting patient’s empowerment, engagement, and rights, they often consider these ideas as a threat to physicians’ professional authority and autonomy. The study leads to the conclusion that due to insufficient training in medical ethics, communication skills, and medical law, many Polish physicians lack the knowledge and competence necessary to adequately respond to challenges posed by modern healthcare practice. (shrink)

This commentary addresses the proposal and argumentative line presented in the paper ‘Whole Body Gestational Donation’ (WBGD) by Anna Smajdor (2023), published as an intended ‘outrageous argument’ in a dedicated special issue of Theoretical Medicine and Bioethics. We believe that the paper is fatally flawed due to its lack of engagement with relevant approaches in ethics and essential sources in health sciences as well as its insufficient, superficial, and rash argumentation. Its critical weaknesses include, among others, that it does not (...) take any explicit ethical stance, it does not consider the societal impacts of its premise, and it hastily assumes a large degree of equivalency between WBGD and the usual organ donations. These scholarly flaws are made worse by the fact that the paper is not merely an academic thought experiment but contains important policy change proposals. As a consequence, the paper feeds into more general and systemic worries about the suitability of philosophy for public policy. (shrink)

In a recent paper, Levy, Gadd, Kerridge, and Komesaroff attempt to defend the ethicality of homeopathy by attacking the utilitarian ethical framework as a basis for medical ethics and by introducing a distinction between evidence-based medicine and modern science. This paper demonstrates that their argumentation is not only insufficient to achieve that goal but also incorrect. Utilitarianism is not required to show that homeopathic practice is unethical; indeed, any normative basis of medical ethics will make it unethical, as a defence (...) of homeopathic practice requires the rejection of modern natural sciences, which are an integral part of medical ethics systems. This paper also points out that evidence-based medicine lies at the very core of modern science. Particular arguments made by Levy et al. within the principlist medical ethics normative system are also shown to be wrong. (shrink)

Pojęcie kompetencji do podejmowania decyzji terapeutycznych jest niezbędne dla teorii i praktyki autonomii pacjenta. Artykuł przedstawia różne podejścia do tego zagadnienia w ramach prawa, filozofii i nauk medycznych oraz wskazuje kierunki rozwoju i integracji badań pomiędzy dziedzinami. Istniejący dorobek analizy pojęciowej, badań empirycznych i rozstrzygnięć prawnych z różnych krajów wymaga dalszego uzgodnienia i wypracowania nowego pojęcia kompetencji zgodnego ze współczesną wiedzą z nauk kognitywnych.