Qualitative Research on Clinical Ethics Consultation in Japan: The Voices of Medical Practitioners / General Medicine

ABSTRACT

<b>BACKGROUND</b> In Japan, clinical ethics support services are only available at certain institutions. The actual conditions surrounding ethics consultation are unclear with few resources available for determining its efficacy. The object of this study is to clarify the expected outcome of ethics consultation and identify the appropriate mode. We also aim to elucidate the ideal consultant and the obstacles to achieving full utilization of ethics consultation.<br><b>METHODS</b> Eighteen medical practitioners participated in the study. We held semi-structured interviews and analyzed these interviews by qualitative content-analysis technique.<br><b>RESULTS</b> This study suggests that specific advice, new insights from outside parties, emotional support, and an appropriate process based on a division of labor between medicine and ethics all contribute to a team-based practice of medicine that avoids the arbitrariness and dogmatism of single practitioners. It is also indicated that timeliness and swift answers are required. Knowledge of medicine and ethics, communication skills, a close familiarity with actual conditions in medical practice, and empathy toward the medical staff were found to be as important as the qualifications of consultants. Contrarily, the participants suggested that the busy pace, lack of psychological breathing room, medical practitioners' pride, lack of awareness of ethical issues, and the negative image of the word “ethics” were significant impediments to achieving full utilization of ethics consultation.<br><b>CONCLUSIONS</b> The present study is the first of its kind to reveal the views of medical professionals regarding clinical ethics consultation in Japan. Further research is required to identify the features of a consultation system that can be easily accessed and effectively utilized in Japan.