Table 2 Case reports and answers to the values considered in the Code of Ethics Virtual Forum of the Catalan Institute of Health. Catalonia, 2008

Competence Capacity and continuing professional development to work to the best of your ability.

A worker with 20 years of experience spots in the intranet a course on multiculturality and migrations for people with her training and during working hours.

a) Dismisses the issue since she considers she is experienced enough and does her job well. b) She asks her manager for leave to do the course. c) She is aware that it is an emerging issue and asks to participate.

Respect Attitude of consideration and care for the patients and their sense of dignity.

You are visiting a patient when a colleague comes and interrupts and starts talking to you; he/she has something to ask you.

a) You listen to your colleague and answer the question, you know it is not the right thing for the patient but it is sort of customary. b) You listen to your colleague, answer the question and when he/she leaves you complain to the patient and apologize. c) You listen to your colleague, explain that you are with a patient and that if it’s not an emergency you’ll get back to him/her. d)You ask the patient if you may answer the question and explain that is it your colleague.

Responsibility Capacity to assume our own decisions and their consequences and to explain them to the people involved.

A patient comes on Sunday at 14.30 when everybody on call is having lunch together.

a) I make the patient wait without explaining until we finish lunch. b) I ask if he/she can wait until we finish. c) I explain that the doctor is busy with an emergency and that he/she will have to wait. d) I ask the patient if he/she can wait, that we are finishing lunch and will be there in 10 minutes. I add that if there is any problem we’ll see him/her immediately.

Confidentiality Moral duty of secrecy and to make a limited and well defined use of the information we hold on the patients.

A relative requests information about your patient in the corridor of your health centre.

a) Tell him or her in the corridor that you cannot provide information because of confidentiality. b) You provide the information. c) You go to an office and provide the requested information. d) You go to an office and explain that you cannot give that information.

Teamwork Coordination of professionals to provide services to patients and the community.

An urgent meeting is scheduled in your department first thing in the morning. When the meeting starts you are still visiting patients.

a) You don’t go (it’s not that important) and finish your clinical work. b) You finish the clinics and go to the meeting, even if it’s late. c) You reorganise your clinical work and go to the meeting pointing out the inconvenience of such short notice. d) You reorganise your appointments first thing in the morning to have enough time to arrive to the meeting when it starts. e) You leave the patients in the waiting room and attend the meeting.

Integrity Capacity to make decisions, to act and to respond of your own behaviour in accordance with professional values.

You meet a pharmaceutical representative in the hospital/primary care centre. He/she invites you to the next congress of your specialty and he/she reminds you of the medicines of his/her pharmaceutical company.

a) I accept, I don’t think this will influence my prescribing. b) I accept, I assume that it influences my prescribing but I’m really interested in this congress. c) I refuse, I understand that I have to pay for my expenses. I would like my department to generally agree to some funding for meetings and training.

Equity Dealing with the circumstances and values of the people fairly without discrimination.

A department in a hospital gets new devices when another department lacks many basics.

a) Inequities must be explained. If resources are prioritized it must be explained. b) The management must avoid another similar situation in the future. c) Management must undertake to improve the worse-off departments.

Innovation Introduction of changes for improvement taking into account risk/benefit.

A health centre invests in new technological devices that are not used for months.

a)There are other priorities and a high healthcare workload. The use of the new devices is postponed. b)The manager of the health centre decides for the devices to be used without training thus limiting the services that they are able to provide. c)The manager of the health centre organises training to optimise use of resources.