Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy.
Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy.
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DOI：
10.4300/jgme-d-16-00010.1
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发表时间：
2016-12-01
影响因子：
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通讯作者：
Konopasek, Lyuba
中科院分区：
文献类型：
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作者：
Ho, Ming-Jung;Alkhal, Abdullatif;Konopasek, Lyuba
背景：关于医学专业精神的《医师宪章》已得到世界各地专业组织的认可，但尚不清楚这一西方专业精神框架是否适用于非西方国家。目的：本研究考察了在中东地区执业的医生如何理解章程中概述的条款、原则和承诺。方法：2013年5月，作者对43名在卡塔尔多哈哈马德医疗公司执业的临床教育工作者进行了6个焦点小组，讨论《医师章程》在当地的适用性。研究小组对成绩单进行编码和分析，以确定社会文化对专业精神的影响。结果：参与者普遍表示同意宪章原则对卡塔尔医师专业精神的适用性。然而，三个背景因素（宗教信仰和习俗、以家庭为中心的决策和多国性）使患者自主和社会公正核心原则的应用复杂化。伊斯兰信仰加强了利他主义等专业价值观的重要性，但对女性患者的自决原则构成了障碍。卡塔尔以家庭为中心的文化要求扩大以病人为中心的决策范围，包括病人的家庭。卡塔尔的多民族人口引发了关于平等待遇以及如何概念化和执行社会正义原则的辩论。结论：几个社会文化背景影响了卡塔尔医疗专业原则的概念化。研究结果表明，在国际环境和背景下制定或采用专业主义框架时，应考虑情境因素。
BACKGROUND: The Physician Charter on medical professionalism has been endorsed by professional organizations worldwide, yet it is unclear if this Western framework of professionalism is applicable in non-Western countries.OBJECTIVE: This study examines how physicians practicing in a Middle Eastern context perceive the terms, principles, and commitments outlined in the charter.METHODS: In May 2013, the authors conducted 6 focus groups with 43 clinician-educators practicing at Hamad Medical Corporation in Doha, Qatar, to discuss the applicability of the Physician Charter in a local context. The research team coded and analyzed transcripts to identify sociocultural influences on professionalism.RESULTS: Participants generally expressed agreement with the applicability of the charter's principles to physician professionalism in Qatar. However, 3 contextual factors (religious beliefs and practices, family-centered decision making, and multinationality) complicated the application of the core principles of patient autonomy and social justice. Islamic beliefs reinforced the importance of professional values such as altruism, but presented a barrier to the principle of self-determination for female patients. The family-centered culture in Qatar called for enlarging the scope of patient-centered decision making to include the patient's family. Qatar's multinational population prompted debate over equal treatment and how to conceptualize and implement the principle of social justice.CONCLUSIONS: Several sociocultural contexts influence the conceptualization of the principles of medical professionalism in Qatar. The findings suggest that contextual factors should be considered when developing or adopting a professionalism framework in an international setting and context.