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How UK and US doctors' ethics differ

By Harris Meyer
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks

21st November 2012 -- UK and US doctors receive medical training so similar that they can readily practice in either the United States or the United Kingdom. They share a common history and culture and speak the same language, more or less.

However, a new survey for Medscape, our sister site for doctors and health professionals, of nearly 25,000 US and UK physicians found that doctors in the two countries hold markedly different views on some thorny medical ethics issues.

There were notable contrasts on attitudes toward what doctors regard as futile care, maintaining patient confidentiality in certain situations, alerting patients about poor-quality physicians, and telling patients the truth about terminal conditions. The biggest difference seen was about whether to defer to the treatment wishes of patients' families.

Medscape's 2012 Ethics Survey Report






Would you ever go against a family's wishes to end treatment and continue treating a patient whom you felt had a chance to recover?

Yes: 57%

Yes: 23%

Is it ever acceptable to perform "unnecessary" procedures due to malpractice concerns?

Yes: 9%

Yes: 23%

Is it right to provide intensive care to a newborn who either will die soon or survive with an objectively terrible quality of life?

Yes: 22%

Yes: 34%

Would you ever hide information from a patient about a terminal or pre-terminal diagnosis if you believed it would help bolster the patient's spirit?

Yes: 14%

Yes: 10%

Would you give life-sustaining therapy if you believed it to be futile?

Yes: 22%

Yes: 35%

Should physician-assisted suicides be allowed in some situations?

Yes: 37%

Yes: 47%

Would you inform a patient if he or she were scheduled to have a procedure done by a physician whose skill you knew to be substandard?

Yes: 32%

Yes: 47%

Is it acceptable to breach patient confidentiality if a patient's health status could harm others?

Yes: 74%

Yes: 63%

Would you ever decide to devote scarce or costly resources to a younger patient rather than to one who was older but not facing imminent death?

Yes: 24%

Yes: 27%

© Medscape 2012

Differences in attitudes between US and UK doctors

Several factors may contribute to the differences: different views toward patient-centered care; a different medical liability climate; the way doctors are paid; national religious attitudes; and the nature of the relationship between physicians, patients and patients' families.

The survey was conducted as part of Medscape's Physician Ethics Report 2012. Survey questionnaires were sent to physicians in a wide range of medical specialties in each country. Completed questionnaires were received from more than 24,000 US physicians and 940 UK physicians. The statistical significance of the differences in responses between US and UK doctors was not calculated.

One obvious difference that could affect attitudes is that most US physicians work either independently or for private hospital and medical groups and receive fee-for-service payment, while in the UK most primary care doctors work directly or indirectly for the NHS. In the UK, most specialists work as salaried staff in NHS hospitals, while most US primary care physicians work independently and receive a mix of fee-for-service payments, per-patient global payments and salary.

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