Abstract

The study investigated first the relationship between the educational and cultural background of physicians and their presently held ethical values and second the role that those values played in the process of physician decision making. ;The purpose of the study was, first, to address how the physician as a professional comes about personal ethical values in relation to cultural and family background beliefs at four specific life points and, second, to what extent, in what manner, and with what outcomes these values played a part in clinical treatment decisions. Outcomes related specifically to the theory of cognitive dissonance and its aftermath of discomfort. The study examined these issues/questions in terms of three current and important human life issues, and whether factors of autonomy, paternalism, human reason, or religion affected the interplay in decision making, in order to find out to what extent a physician's values and decisions were affected by autonomy, paternalism, tradition, natural law, religion, and other social factors. ;The study was exploratory in nature. The means employed for data collection consisted of a research questionnaire, selected physician interviews, and field observations of a hospital ethics committee. Analysis of the interviews and field observations were compared with the questionnaire findings. ;The study interpreted and evaluated data generated by the following questions: Does the physician believe that the physician should be involved in the purposeful attempt to terminate innocent born human life? Does the physician believe that a woman's right to privacy and control over her body supercedes the physician's obligation to preserve the right of innocent unborn human life? Does the physician believe that the withholding/withdrawing of medically assisted nutrition and hydration is a removal of medical treatment or the removal of basic care that respects and preserves innocent human life? ;In attempting to answer these questions, the following propositions were promulgated: Ethical values regarding human life which physicians learn from their cultural background, early upbringing, and medical codes affect their clinical decision making, resulting in discomfort about the decision made; The discomfort experienced by physicians in clinical decision making on human life issues are due to the widely accepted view, grounded in human reason and reinforced in medical codes, that supports and protects innocent human life under all conditions. ;If the research demonstrated sufficient evidence of positive and/or negative relationships between physicians' ethical values and their medical practice decisions in the delivery of health care, then such an investigation could yield important contributions, emphases, and directions to future medical ethics curricula in education and to the resolution of difficult scenarios in the health care setting without, at the same time, damaging cherished values of either patient or physician