Medical professionalism, which is of great interest in most countries, underpins the relationship between patients and doctors. The concepts of medical professionalism should be understandable not only by physicians but also by patients. However, there are few studies that evaluate the concept of medical professionalism from patients' perspective.a) We conducted two focus group interviews with 12 people who were not health care professionals. One interview was done with people who were living in Tokyo and one with people living in Osaka. Each interview was one hour long. During the interviews, we explored themes related to medical professionalism from patients' perspectives.b) We qualitatively analyzed response data from audio records of the interview and inductively extracted categories pertaining to medical professionalism. We compared our findings with the domains of the American Board of Internal Medicine's Charter on Professionalism (CP).c) We found 5 themes; 1) Primacy of patient welfare 2) Fairness 3) Social responsibility 4) Maintaining appropriate relations with industry 5) Maintaining appropriate relations with patients.d) Although our themes are almost equivalent to the principles cited in CP, there are some differences, such as the importance of maintaining appropriate relations with patients.e) Given the current findings, medical educators and trainers should continue to develop the Japanese concepts of medical professionalism in a manner that takes into consideration patients' perspectives.

BACKGROUND : In Japan, clinical ethics support services are only available at certain institutions. The actual conditions surrounding ethics consultation are unclear with few resources available for determining its efficacy. The object of this study is to clarify the expected outcome of ethics consultation and identify the appropriate mode. We also aim to elucidate the ideal consultant and the obstacles to achieving full utilization of ethics consultation.
METHODS : Eighteen medical practitioners participated in the study. We held semi-structured interviews and analyzed these interviews by qualitative content-analysis technique.
RESULTS : This study suggests that specific advice, new insights from outside parties, emotional support, and an appropriate process based on a division of labor between medicine and ethics all contribute to a team-based practice of medicine that avoids the arbitrariness and dogmatism of single practitioners. It is also indicated that timeliness and swift answers are required. Knowledge of medicine and ethics, communication skills, a close familiarity with actual conditions in medical practice, and empathy toward the medical staff were found to be as important as the qualifications of consultants. Contrarily, the participants suggested that the busy pace, lack of psychological breathing room, medical practitioners' pride, lack of awareness of ethical issues, and the negative image of the word “ethics” were significant impediments to achieving full utilization of ethics consultation.
CONCLUSIONS : The present study is the first of its kind to reveal the views of medical professionals regarding clinical ethics consultation in Japan. Further research is required to identify the features of a consultation system that can be easily accessed and effectively utilized in Japan.