Evaluation of physicians' perspectives and awareness on current practices involving medical dilemmas

Objective: This study aimed to assess the approaches of physicians working in various specialties and regions of Türkiye to current medical dilemmas they have encountered or may encounter throughout their professional lives. Based on the findings, the goal was to identify potential shortcomings in their approach and offer recommendations to address these gaps. Materials and Methods: A total of 304 physicians—including general practitioners, residents from various specialties, and specialist physicians—were presented with a 16-item questionnaire consisting of scenario-based statements. The required sample size was determined using G-Power analysis to ensure statistical significance. The reliability of the questionnaire was tested using Cronbach's Alpha. The survey was administered online via Google Forms. Data were analyzed using IBM SPSS Statistics version 26. Quantitative variables were presented as means and standard deviations, and qualitative variables were presented as frequencies and percentages. A significance level of α = 0.05 was adopted. Results: In our study, a total of 304 physicians (female: 54.3%, male: 45.7%) working in various specialties across different regions of the country and who completed the questionnaire via Google Forms were included. The median age range of participants was between 30 and 39 years. Regarding the statement suggesting that a genital examination should be performed on a girl who refuses the procedure despite a court order, 44.7% of the physicians responded with "Strongly Disagree," and 24.3% with "Disagree." For the statement about examining a detainee while handcuffed, 40.5% of the participants responded with "Strongly Disagree," and 25.0% with "Disagree." In response to the statement that a mentally disabled child could be discharged home upon obtaining a signed consent form, 40.8% of the physicians stated "Strongly Disagree," and another 40.8% stated "Disagree." Concerning the statement on sharing pre- and post-procedure photographs related to aesthetic and cosmetic practices on social media without revealing the patient's identity, 53.6% of the participants agreed with the statement, 38.4% (n=117) disagreed, and 7.9% (n=24) were undecided. For the statement that medical intervention should be initiated when a person on hunger strike loses consciousness, 77.6% (n=236) of the physicians answered "Strongly Agree/Agree," 12.1% (n=37) answered "Strongly Disagree/Disagree," and 10.2% (n=31) were undecided. In response to the statement regarding performing a medical examination outside a healthcare facility, 32.6% of the participants disagreed. For the statement suggesting that a single physician could perform an autopsy, 29.6% of the participants disagreed, while 27.0% agreed. Conclusion: Throughout their careers, physicians frequently encounter situations where medical ethics and legal obligations do not align or even conflict. They are expected to effectively manage such ethical-legal dilemmas. Therefore, it is essential for all physicians to be knowledgeable about forensic medicine practices, professional ethical responsibilities, and the national and international regulations that guide these responsibilities. To better prepare physicians for these complex situations, it is of great importance to develop specialized training programs, standardize existing ones, and regularly update them in line with the evolving needs of the healthcare system. Keywords: Forensic medicine, medical dilemma, medical ethics, physicians' approach