A Draft Ethics Curriculum Based on Ethical Issues Experienced by Family Doctors in Düzce

Aim: To determine ethical issues experienced by family doctors in Düzce, the pilot province for implementation of the primary health care reform 'Transformation in Health' in Turkey in 2005.Method: We conducted this study between May and June 2007 in Düzce. A self-administered-questionnaire prepared by the researchers included 13 ethical issues inquiring about physicians' frequency of encounter, difficulty in managing the problem, and learning needs in ethical topics. Results: Fifty-seven percent of family doctors who were practicing in Düzce (56/98) took part in the study. Most of them (89.3%) were in practice over a year, had more than 3000 registered patients (80.4%) with homogenous distribution (67.9%). Physicians reported to encounter ethical dilemmas related to informed consent (72.7%), conflict of self-interest and altruism (44.6%), determining competency (41.8%), claims of alternative therapy (41.0%), relationship with representatives of drug companies (39.2%), truth-telling (28.6%), and resource allocation (27.3%) at least once a month. Participants were experienced difficulties when solving dilemmas related to determining competency in patients, reporting incompetency of a colleague, informed consent, best interest of the child, truth-telling, conflict of self-interest and altruism, respectively. Best interest of the child, truth-telling, determining competency in patients, protecting others' interest and gaining informed consent were prioritized topics for education. Conclusion: Our results implied that family doctors experienced difficulties in ethical conduct during daily clinical practice. The most frequently mentioned ethical issues were evaluated with respect to expressed learning needs which served to develop a draft ethics curriculum.