Knowledge of, and attitudes toward, codes of ethics and associated factors among medical doctors in Addis Ababa, Ethiopia

Figures & data

Table 1 Sociodemographic characteristics of medical doctors in Addis Ababa, 2017 (n=490)

Variables	n	%
Sex
Male	302	61.6
Female	188	38.4
Age, years
25-29	249	50.8
30-34	142	29.0
>34	99	20.2
Religion
Orthodox Tewahedo	312	63.7
Catholic	22	4.5
Protestant	82	16.7
Muslim	55	11.2
Others*	19	3.9
Level of education
General practitioner	317	64.7
Specialist	173	35.3
Work experience, years
<4	228	46.5
4-7.9	179	36.5
>8	83	16.9
Level of satisfaction
Satisfied	307	62.7
Dissatisfied	183	37.3

Table 2 Institutional factors for practice of code of ethics among medical doctors in Addis Ababa, 2017 (n=490)

Variables	n	%
Type of hospital
Governmental	413	84.3
Private	77	15.7
Took medical ethics course
Yes	449	91.6
No	41	8.4
Had training on code of ethics/medical ethics
Yes	81	16.5
No	409	83.5

Table 3 Knowledge about existence of code of ethics and FHPEC among medical doctors in Addis Ababa, 2017 (n=490)

Variables	n	%
Knowledge about existence of code of ethics
Yes	365	74.5
No	125	25.5
Knowledge about existence of FHPEC
Yes	275	56.1
No	215	43.9
Knowledge about powers and duties of FHPEC (n=275)
Yes	95	34.5
No	180	65.5

Table 4 Univariate and multivariate analysis of factors associated with knowledge of code of ethics among medical doctors in Addis Ababa, 2017 (n=490)

Variables	Knowledge		COR (95% CI)	AOR (95% CI)	P-value
	Knowledgeable	Not knowledgeable
Sex
Male	217	85	0.564 (0.360–0.882)	0.582 (0.357–0.951)	0.031*
Female	154	34	1.00	1.00
Age, years
25-29	191	58	0.997 (0.612–1.624)	1.281 (0.704–2.331)	0.481
30-34	109	33	1.00	1.00
>34	71	28	0.768 (0.427–1.379)	1.219 (0.506–2.936)	0.659
Level of education
General practitioner	233	84
Specialist	138	35	1.421 (0.909–2.223)	2.048 (1.125–3.726)	0.019*
Type of hospital
Governmental	314	99	1.113 (0.637–1.943)	0.792 (0.410–1.531)	0.488
Private	57	20	1.00	1.00
Work experience
<4 years	175	53	1.012 (0.637–1.608)	1.243 (0.718–2.153)	0.436
4-7.9 years	137	42	1.00	1.00
>8 years	59	24	0.754 (0.419–1.356)	0.666 (0.264–1.678)	0.389
Training
No	316	93	1.00	1.00
Yes	55	26	0.623 (0.370–1.048)	0.632 (0.351–1.137)	0.126
Level of satisfaction
Satisfied	231	76	0.934 (0.608–1.434)	0.841 (0.522–1.356)	0.478
Dissatisfied	140	43	1.00	1.00
Attitude
Favorable	260	38	4.993 (3.200–7.790)	5.229 (3.300–8.286)	<0.001*
Unfavorable	111	81	1.00	1.00

Table 5 Responses to attitude-related questions on code of ethics among medical doctors in Addis Ababa, 2017 (n=490)

Statements of code of ethics	Strongly agree, n (%)	Agree, n (%)	Neutral, n (%)	Disagree, n (%)	Strongly disagree, n (%)
Medical doctors shall obtain informed consent from a patient before rendering a service	327 (66.7)	130	17(3.5)	7(1.4)	9(1.8)
		(26.5)
Medical doctors shall respect patient confidentiality, privacy, choices, and dignity	413 (84.3)	69 (14.1)	6(1.2)	2 (0.4)	0 (0.0)
Medical doctors may provide a health service for their benefit that does not serve the needs of their patient	7(1.4)	32 (6.5)	36 (7.3)	104 (21.2)	311 (63.5)
A medical doctor may work with or give any professional support to other health professionals not licensed by an appropriate organization	21 (4.3)	77(15.7)	103 (21.0)	121 (24.7)	168 (34.3)
No medical doctor may render the same level of care to his/her clients/patients in overtime and regular practice	25 (5.1)	101	56 (11.4)	149 (30.4)	159 (32.4)
		(20.6)
Any medical doctor may provide any preferential treatment to a client/patient by considering the relationship established with him/her in other health institutions where the same medical doctor works	28 (5.7)	60 (12.2)	67 (13.7)	159 (32.4)	176 (35.9)
A medical doctor may use secret remedies to treat a patient	38 (7.8)	67 (13.7)	57 (11.6)	137 (28.0)	191 (39.0)
Any medical doctor shall use an apparatus or health technology that has been proved upon investigation to be capable of fulfilling the claims made in regard to it	220 (44.9)	175	47 (9.6)	25 (5.1)	23 (4.7)
		(35.7)
A medical doctor may refuse on grounds of personal belief to provide such services as contraception, legal abortions, and blood transfusions	57 (11.6)	91 (18.6)	74 (15.1)	119 (24.3)	149 (30.4)
A medical doctor shall sign and write his/her name on official documents relating to patient care, such as laboratory and other diagnostic requests and results, prescriptions, certificates, patient records, and other reports	348 (71.0)	104	18 (3.7)	7(1.4)	13 (2.7)
		(21.2)
A medical doctor shall issue genuine and complete sick leave or certificates of illness	370 (75.5)	102	11 (2.2)	4 (0.8)	3 (0.6)
		(20.8)
A medical doctor may prescribe medicine or formulations about which he/she has no knowledge on composition or pharmacological action	17(3.5)	11 (2.2)	40 (8.2)	124 (25.3)	298 (60.8)
Medical doctors may prescribe medicine not registered in the National Medicine List without compelling reason	11 (2.2)	38 (7.8)	62 (12.7)	147 (30.0)	232 (47.3)
Any medical doctor shall report an impairment in another health professional to the appropriate organization	147 (30.0)	160	115 (23.5)	40 (8.2)	28 (5.7)
		(32.7)
A medical doctor shall report his/her own impairment to the appropriate organization	167 (34.1)	180	104 (21.2)	26 (5.3)	13 (2.7)
		(36.7)
A medical doctor shall report any unprofessional conduct of another health professional to the appropriate organization	186 (38.0)	158	82 (16.7)	38 (7.8)	26 (5.3)
		(32.2)

Table 6 Univariate and multivariate analysis of factors associated with attitudes toward codes of ethics among medical doctors in Addis Ababa, 2017 (n=490)

Variables	Attitude		COR (95% CI)	AOR (95% CI)	P-value
	Favorable	Unfavorable
Sex
Male	181	121	0.908 (0.624–1.320)	1.096 (0.724–1.658)	0.666
Female	117	71	1.00	1.00
Age, years
25-29	148	101	0.702 (0.455–1.083)	0.833 (0.486–1.425)	0.504
30-34	96	46	1.00	1.00
>34	54	45	0.575 (0.339–0.976)	0.472 (0.214–1.042)	0.063
Level of education
General practitioner	186	131	1.00	1.00
Specialist	112	61	1.293 (0.881–1.898)	1.321 (1.014–3.144)	0.025*
Type of hospital
Governmental	257	156	1.447 (0.886–2.361)	1.462 (0.829–2.576)	0.189
Private	41	36	1.00	1.00
Work experience
<4 years	133	95	0.742 (0.495–1.112)	0.752 (0.460–1.227)	0.254
4-7.9 years	117	62	1.00	1.00
>8 years	48	35	0.727 (0.426–1.239)	1.343 (1.051–3.091)	0.035*
Training
No	250	159	1.00	1.00
Yes	48	33	0.925 (0.569–1.504)	1.069 (0.621–1.839)	0.809
Level of satisfaction
Satisfied	193	114	1.258 (0.866–1.827)	1.356 (0.901–2.040)	0.144
Dissatisfied	105	78	1.00	1.00
Knowledge
Knowledgeable	260	111	4.993 (3.200–7.790)	5.208 (3.286–8.252)	<0.001*
Not knowledgeable	38	81	1.00	1.00