Akademik Veri Yönetim Sistemi
Klinik Psikiyatri Dergisi, cilt.25, sa.2, ss.177-183, 2022 (ESCI)
© 2022 ANP Publishing. All rights reserved.Objective: The aim of this study is to demonstrate the level of reconciliation between different medical branches, decision-making processes over the same facts, both among themselves and with others. Method: An online survey was created with three cases and six questions in the grey area related to the decision-making capacity (DMC) situations. Surveys were sent to participants through their e-mails registered in hospital systems. A total of 165 physicians participated in the study. The first scenario concerned an unstable patient with gastrointestinal bleeding and major depression requesting discharge despite medical advice. The second scenario included the discharge request of a patient who was on the border of pulmonary insufficiency with a severe asthma attack. The final scenario was about a homeless person with chest pain that occurred at the time of alcohol withdrawal, demanding discharge, at a point where a heart attack wasn’t excluded. Results: 54% of psychiatry specialists, 77% of psychiatry residents, 82% of emergency medicine specialists and 76% of emergency medicine residents stated that DMC was intact for scenario 1. For scenario 2, these rates were determined as %88, %90, %76, %71 while for scenario 3 they were %44, %35, %44 and 47%, respectively. Among the psychiatrists and residents, a statistically significant difference was found between the two groups only in scenario 1. Discussion: : Consistent with the literature, it was observed that the interrater agreement of DMC decisions between different medical branches was low. Differences can be explained by different experience years, educational differences, evaluating basic decision-making competencies with different degrees of importance and differences in malpractice concerns.