Background: Ethical dilemmas routinely arise at emergency departments in hospital setting.rnPhysicians, patients and patient families are face a problem of choice and decision makingrnbecome difficult in terms of ethics. There are also numbers of ethical dilemmas in emergencyrncare; because it is different from other department in terms of need of quick intervention to savernlife, unknown history of patient, scarce resources, family culture and/ or beliefs, and emergencyrndepartment crowdedness.rnObjectives: To assess ethical dilemmas and decision making process in emergency departmentsrnof public hospitals: experiences of physicians working in public hospitals, Addis Ababa,rnEthiopia.rnMethods: Institutional based descriptive cross-sectional study using a self-administered,rnstructured questionnaire.rnResult. The study included 106 physicians of which 62(58.5%) male and 44(41.5%) female.rnFrom open ended questions physicians were asked the most common ethical dilemmas theyrnencountered in emergency department and 42 physicians 21(50%) respond that it is againstrnmedical advice due to economic problem, 12(28.5%) decision for unconscious patient with nornfamily and 9 (21.5%) disagreement with family on treatment option for unconscious patient.rnNearly 72% 0f physicians encounter ethical dilemmas in emergency departments because therernis no guideline for the admission of patient to intensive care unit and operation room.rnConclusion: Physicians routinely challenge with ethical dilemmas and face difficult decisionrnmaking process in emergency department during their medical practices. The main sources ofrnethical conflict in the department are scarce resource, treatment option for unconscious patientrnwith no family members, disagreement of family and physician on treatment option forrnunconscious patient and having many patients or emergency room crowdedness.rnKey words: Ethical dilemmas, decision making process, physicians, emergency departments,rnpublic hospitals