Table 1. Sample quotations from interviews illustrating clinician’s values.
Respect Autonomy |
“Information is to be kept between the doctor and the patient, period. If the family member asks me for information about the patient but the patient is conscious and has asked me not to give out any relevant information, I don’t.” |
Non-discrimination | “Irrespective of whether the patient may have killed or injured someone, he is a human being [… and] as a person must be cared for.” |
Autonomy |
“Euthanasia should be accepted because there are many times that the patient is suffering a lot […] I think you have to respect what he says, respect his autonomy.” |
Multiculturalism |
“I used to think that if the patient refuses to be transfused and this procedure was necessary, if I am a doctor, I must do it because I studied medicine to save lives, but this changed with the course. In the course we talked a lot about respect for patients and respect for their beliefs. This happens very often with people of certain religions for example with Jehovah's Witnesses.” |
Fruitful communication |
“I spoke to her for maybe three days, telling her that it was the best option for her to be able to go on with her life, although maybe not with the same quality of life, but that there were alternatives, that she shouldn’t give up.” |
Confidentiality Responsibility to others |
“In the case of a contagious disease, where people are living in close quarters, well, yeah, we have to explain to the person who is requesting [confidentiality] that he has such a great responsibility toward the other person precisely because of his circumstances” |
Responsibility of patients |
“I have always been convinced that patients should have a certain amount of responsibility, and if you take all responsibility away from them, they become very coddled.” |
Support network |
“When a tough decision has to be made, depending on the case, I have needed outside opinions. […] To give or reinforce information about a patient, which is our job, to explain to the family member about the problems she is facing […] I have to inform the patient, but based on what? […] That’s why I [as a clinician] have to become informed about everything, [… and] research together with the people involved in the case in order to make a decision about it.” |
Empathy Dignity Autonomy |
“When something hurts you, multiply it by a thousand and you’ll see things from the point of view of a cancer patient, right? Imagine the pain you feel; the patient feels it every day, not even morphine makes it go away, nor will the best medicines make it go away either.” |
Empathy Autonomy |
“No, well, it’s artificial. I believe that when there’s no sign of life, no brain activity, and being hooked up doesn’t make sense, it doesn’t make sense to keep him like that. Yes it’s a life, but that life is suffering, you know, so even if he can’t express himself or anything, he is suffering. In that case, I don’t think it’s humane, from my point of view, it isn’t humane.” |