Does sociodemographic background determine the responses to ethical dilemma vignettes among patients?

Abstract

Background and Aims: Patients are important stakeholders in the care process and may have different viewpoints on clinical disclosure, which may be influenced by their sociodemographic and cultural background. Hence, the aim of this study was to assess whether age, gender, employment status, educational status, and other sociodemographic variables of persons with mental illness influence their views about ethical issues in clinical care. Materials and Methods: The study was conducted at the Outpatient Department of a tertiary care mental health/de-addiction center in North India. Patients aged ≥18 years and currently in remission of their primary psychiatric illness were included. Using case vignettes, their responses to ethical issues related to clinical situations were assessed. Results: The study included a total of 160 participants. The younger age group less frequently agreed on disclosure of a man's Human Immunodeficiency Virus-positive status to other family members against his wishes. Women less frequently agreed on disclosure of marital strife to husbands' parents. Higher educational status was associated with a less frequent agreement to disclosure of a man's suicidal ideas to other family members, and those currently employed less frequently agreed to disclosure of marital strife of a female patient to her parents. Conclusion: Age, gender, education, and employment status might influence some of the responses to ethical dilemmas in the clinical setting. These factors may be considered while clinical decision-making faces ethical challenges.

Keywords

• Confidentiality
• ethics
• mental health
• patient
• sociodemographics Key message: Ethical issues in health-care are important concerns
• but are infrequently discussed. This paper explores whether demographic factors have an influence on the way patients and their family members discern and resolve ethical conundrums.