Attitudes of residents concerning ethical dilemmas with pediatric patients <b>[Abstract in English]</b>

Abstract

Objective: To evaluate the attitudes of residents concerning ethical dilemmas through questionnaires describing pediatric clinical situations applied one year apart. Methods: A cohort of 85 medical residents answered to a questionnaire with three pediatric clinical cases modified from a previously validated survey. The clinical cases proposed to the residents in two different periods, one year apart, contemplated the principles of justice, beneficence and autonomy. No other educational interventions were done during this time. Measurements and main results: Eighty five residents answered to the survey (47 pediatric and 38 nonpediatric residents) from a total of 106. The inter-rater agreement between the two survey periods (2002 vs 2003) to the presented clinical cases contemplating the principles of justice, beneficence and autonomy was respectively Kappa (IC95%) = 0,20; 0,21 e 0,10, showing that ethical attitudes changed significantly after an one year internship program. The exception was regarding the principle of justice, among males with a moderate inter-rater agreement (K = 0,42). Conclusions: After a 12 months internship program there was change in attitudes of medical residents towardethical dilemmas among pediatric patients, independent of any specific training or formal discussions on bioethical issues. A moderate inter-rater agreement was detected between male gender and the question relating to the principle of justice. There was also a positive association between the tendency to address the criterion of necessity related to the principle of justice and feminine gender, in the Pediatric area. It is important that educative Bioethical measures are implemented during the residency in Pediatrics.