Abstract：
Background Ethical conflicts generate difficulties in daily clinical activity. Which methods of ethical advice are most frequently used to resolve them among Spanish doctors has not been studied. The objective of this study is to describe what methods hospital internal medicine physicians in Spain use to resolve their ethical doubts and which they consider most useful. Design A cross-sectional observational study was conducted through a voluntary and anonymous survey and distributed through an ad hoc platform of the Spanish Society of Internal Medicine. Measures We measured methods by which to resolve doubts, types of tools sought, frequency of consulting the Clinical Ethics Committees, and satisfaction with resolution of ethical issues. Results Of 261 internists surveyed, 86 per cent resolve their ethical doubts with assistance, the most frequently used method being consultation with colleagues (58.6 per cent), followed by using specific protocols or guides (11.8 per cent) and consultation with experts in bioethics (9.6 per cent). The most preferred tools are the creation of protocols (30.3 per cent) and the establishment of a consultant/expert in bioethics (27.8 per cent). Conclusions Internists in Spain usually seek assistance to resolve their ethical doubts. Consulting colleagues is the most frequently adopted method. The majority regard tools to resolve ethical conflicts as necessary, seeking above all protocols and consultants/experts in bioethics.
摘要：
背景技术伦理冲突在日常临床活动中产生困难。尚未研究在西班牙医生中最常用的道德建议方法来解决这些问题。这项研究的目的是描述西班牙的医院内科医师使用什么方法来解决他们的道德疑虑，以及他们认为最有用的方法。设计通过自愿和匿名调查进行横断面观察研究，并通过西班牙内科学会的特设平台进行分发。措施我们衡量了解决疑虑的方法，寻找的工具类型，咨询临床伦理委员会的频率，以及对解决道德问题的满意度。在接受调查的261名内科医生中，86%的人在协助下解决道德疑虑,最常用的方法是咨询同事(58.6%)，其次是使用具体的协议或指南(11.8%)和咨询生物伦理学专家(9.6%)。最优选的工具是创建协议（30.3％）和建立生物伦理学顾问/专家（27.8％）。结论西班牙的内科医生通常寻求帮助以解决他们的道德疑虑。咨询同事是最常用的方法。大多数人认为解决道德冲突的工具是必要的，首先寻求生物伦理学方面的协议和顾问/专家。
