Technological advances, regulations and pressures to control costs are leading to more ambiguity and ethical dilemmas, according to a new report from Medscape.

Medscape, a division of WebMD, surveyed 24,000 U.S. doctors in 25 specialties on ethical issues regarding defensive medicine, end-of-life care and conserving healthcare resources.

In one question, physicians were asked if it was ever acceptable to prescribe a placebo to a patient who didn't require treatment but was adamant about receiving it, and 34% said yes, 48% said no and 18% said “it depends.”

Physicians were pretty adamant about how they are not influenced by a free meal from a pharmaceutical salesperson. When asked if they could be unbiased with prescribing if they accept lunch from a drug company representative, 72% said yes, 20% said no and 8% said it depends.

Answers were split almost evenly across the board when asked if they would ever dismiss a nonadherent or resource over-using patient on a capitation plan. Thirty-two percent said yes, 33% said no and 35% said it depends.

In answering a question on whether physician-assisted suicide should be allowed in some situations, 47% said yes, 40% said no and 13% said it depends.