Showing 268 results for Ethics
Mostafa Roshanzadeh, Ali Taj, Somayeh Mohammadi,
Volume 17, Issue 1 (3-2024)
Abstract
In the current health system conditions, the strategies adopted by nursing managers in their ethical decision-making can lead to different results for patients, nurses, and health systems. Therefore, the present study aimed to explain ethical decision-making strategies implemented by nursing managers. The present study was conducted using qualitative content analysis in 2022 at Shahrekord University of Medical Sciences. A total of 18 nursing managers were selected through purposive sampling and were interviewed using in-depth unstructured individual interviews. Data were analyzed using the method proposed by Graneheim and Lundman. The results revealed one main category (human-centeredness) and three subcategories (customer-centeredness, valuing employees’ dignity, and the conflict between respecting the rights of patients and employees and adhering to organizational policies). Nursing managers attempted to make their ethical decisions based on the principle of humanism by using customer-centeredness strategies, valuing employees’ dignity, and prioritizing the rights of individuals and employees over organizational rules. The results of the present study showed nursing managers make decisions in line with respecting the rights of patients and employees. However, sometimes these decisions conflict with the interests of organizations. In this regard, the existing obstacles that create the conditions for such conflicts should be identified. Increasing organizational commitment in managers can also be effective in decisions that benefit different groups of customers, personnel, and health organizations.
Saeed Nazari Tavakkoli, Saeed Ghadirzadeh Toosi,
Volume 17, Issue 1 (3-2024)
Abstract
Treating patients whose lives are in danger or threatened by irreparable harm, is an obligatory act. However, sometimes, due to old age, the severity of the disease, or the lack of definitive treatment, the patient faces a situation where, according to the diagnosis of the medical staff, starting or continuing the treatment has no effect on patient recovery, or the effect is so insignificant that is ignored in medical practice. This study was conducted using a descriptive and analytical method based on library resources to compare “futile treatment” in medical ethics with “Israf” (extravagance) in Islamic jurisprudence so as to indicate the level of conceptual compatibility between these two concepts. Moreover, considering the illegitimacy of extravagance in jurisprudential teachings, it was attempted to explore whether it is illegitimate, according to Islamic rules, to perform futile treatment. To do so, first, futile treatment and its characteristics in medical texts were defined. Second, the ethical considerations of performing such treatment were explained based on the teachings of medical ethics. Third, extravagance was analyzed in terms of concept, topic, and sentence by referring to valid lexical, jurisprudential, narrative, and interpretative resources. Finally, based on a comparative study, the level of compatibility of futile treatment with extravagance was investigated. The findings of this study showed futile treatment is an example of extravagance as it causes the waste of personal or public property, lacks rational purpose, and does not lead to patient recovery or promotion of health status. Therefore, futile treatment is not considered an obligatory act but even an illegitimate one as it is a clear example of extravagance. In addition to punishment in the afterlife, it entails civil liability as it results in the loss of others’ property.
Rahele Samouei, D Farzane Mohammadi-Sefiddashti, Narges Meshkineh, Mostafa Amini-Rarani ,
Volume 17, Issue 1 (3-2024)
Abstract
Compliance with ethical principles in research by researchers plays a fundamental role in providing evidence-based and practical findings, subsequently solving society's problems and advancing knowledge. Despite numerous educational workshops and awareness-raising efforts, some unethical research practices are still observed. Identifying relevant factors is essential for practical and preventive planning. In this regard, the present study aimed to identify psychosocial determinants related to the ethical performance of researchers in conducting and publishing research works. The study was conducted using a qualitative approach based on conventional content analysis. A total of 29 faculty members and researchers from the medical sciences universities in Iran in various fields and specialties were selected purposively and semi-structured interviews were conducted with the participants. Qualitative content analysis was used to categorize data and Lincoln and Guba’s criteria were employed to evaluate data. Data analysis led to the identification of 136 codes, 20 subcategories, and 4 main categories. The factors related to the ethical performance of researchers in conducting and publishing research works derived from interviews with researchers included "Laws", "Social Learning", "Knowledge and Literacy", and "Psychological Characteristics". According to the findings of this study, the ethical performance of researchers in the field of research is the result of the interaction of social, individual, personality, and legislative factors. Some factors, like personality traits, are long-lasting, resistant, and personal, while social factors are widespread, common, and more general. Research policymakers and managers can improve the ethical performance of researchers and place ethics at the center of attention in research by implementing educational methods, culture building, and behavior change
Mitra Bahrami, Mohadeseh Shaygan Jamal, Maryam Afshari, Omid Najm Roshan,
Volume 17, Issue 1 (3-2024)
Abstract
Research ethics is a branch of professional ethics that deals with the ethical principles guiding the research process from the beginning to the end. Ignoring ethical issues in research sometimes occurs unintentionally and simply due to a lack of awareness regarding professional research ethics. Therefore, this study aimed to identify facilitators and inhibitors of adherence to ethics in research conducted by postgraduate students at Hamadan University of Medical Sciences. This qualitative study was conducted using an inductive content analysis approach. The target population included postgraduate students at Hamadan University of Medical Sciences. Data were collected through semi-structured interviews with 29 students who were selected using purposive sampling. Data were analyzed using the method proposed by Diekelmann et al. For data validation, Strauss and Corbin’s method was utilized. Factors influencing adherence to research ethics included individual and personality traits (accuracy and ethical conduct of students and professors and having sufficient information about research ethics) and environmental factors (information dissemination and familiarity with research methods, the professors’ interactions with students, confidentiality of information, strictness of professors, having a clear framework from the university, respecting students’ rights, and establishing deterrent regulations). Strengthening facilitators and mitigating inhibitors of adherence to research ethics requires joint efforts from students, professors, and the university. Students need to develop accuracy and awareness, and professors should serve as ethical role models. University officials are required to create and propose clear frameworks for adhering to ethics, to be followed by all individuals involved in research.
Ehsan Shamsi Gooshki,
Volume 17, Issue 1 (3-2024)
Abstract
Defensive medicine refers to actions taken by doctors and other medical professionals to protect themselves against potential threats and risks, particularly to prevent patient complaints or convictions in court, which is carried out in various forms including positive and negative defensive medicine. Since the primary motivation behind such actions, often viewed as morally unjustified, is to avoid legal proceedings and lawsuits, court rulings against doctors can intensify these behaviors. Reports of criminal sentences against some doctors in Iran and reactions from professional associations highlight the significance of this issue. This study examined the effects of such sentences on the healthcare system by referring to available documents and data on the widespread prevalence of defensive medicine in Iran, offering some suggestions for managing the issue. The objective of the study was to emphasize the importance of acknowledging the defensive motivations of doctors in healthcare and its influential factors, particularly the fear of criminal convictions, which can increase defensive behaviors among doctors and amplify their negative impacts on the healthcare system.
Nehleh Zarei-Fard, Sedigheh Ebrahimi,
Volume 17, Issue 1 (3-2024)
Abstract
Medical science and ethics form an integral part of medical curricula. Cadaver dissection is the preferred educational tool in the early stages of medical education which provides a suitable opportunity to sow the seeds of medical ethics in the minds of future physicians. This review study aimed to investigate unethical events in the history of dissection and subsequent ethical evolutions in human dissection to highlight the need to uphold the ethical values related to donor bodies in the dissection hall. To find and evaluate related documents, the articles published from 2005 to 2023 were searched in Scopus, PubMed, Google Scholar, and Research Gate databases using relevant keywords. The results indicated that in the past, cadaver dissection was performed on the bodies of executed criminals or through illegal methods, and until the early 1960s, the ethical principle of respect for autonomy was overlooked. However, from the 20th century onwards, the use of donated bodies with informed consent became prominent, allowing universities in the 21st century to utilize this resource for education, thereby providing an acceptable solution to fill the ethical gaps in dissection. Clarifying the ethical standards associated with the use of donated bodies is essential for medical students. The human body represents a valuable scientific resource that warrants respectful treatment following established ethical guidelines and laws. Adhering to the highest ethical standards within educational institutions is necessary to ensure donors feel confident in their decisions.
Hosein Fasihi, Dr. Syyed Ahmad Fazeli,
Volume 17, Issue 1 (3-2024)
Abstract
In the realm of philosophy, numerous thinkers have offered profound, and at times amazing, insights into the nature of existence. Among them, Spinoza stands out with his unique perspective, establishing a deep connection between ethics, religion, and the divine nature. Spinoza posits that religious texts, beyond their religious teachings, serve a motivational role in inspiring moral behavior. He locates the foundation of virtue within human nature and essence, arguing that the moral quality of actions is not inherent but is derived from God as the ultimate source of good and evil. Ultimately, adhering to the principle of universal necessity, Spinoza extends this concept to ethics, viewing it as an expression of divine nature. This perspective implies that morality and all human actions unfold within the framework of natural and divine necessity. An examination of Spinoza's views reveals a profound unity between humanity and the divine, characterized by a harmonious and interactive relationship between religion and ethics. Within Spinoza's philosophical system, these two categories are aligned, guiding individuals toward happiness and virtue. This innovative approach not only enriches our understanding of Spinoza's thought but also, by bridging religion, reason, and health, opens avenues for reconsidering medical ethics and spirituality in the contemporary world. This study, through a critical analysis of Spinoza's views, lays the groundwork for future investigations into moral philosophy, religion, and medical ethics, fostering a constructive dialogue between tradition and modernity.
Sooreh Khaki, Masoud Fallahi -Khoshknab, Farahnaz Mohammadi-Shahboulaghi, Gülbeyaz Can, Mohammad Ali Hosseini,
Volume 17, Issue 1 (3-2024)
Abstract
Conveying bad news to patients and their families is a process that requires team collaboration. Different countries have taken into consideration providing suitable solutions. This study aimed to develop an practical guideline, according to the experiences of patients, families, and healthcare providers in intensive care units across three phases. In the first phase, in-depth interviews were conducted with 31 participants selected through purposive sampling, and the initial draft of the practical guideline was created. In the second phase, the initial draft was discussed and reviewed by experts in two focus group meetings, and a secondary draft was developed. In the third phase, the practical guideline compiled by the Delphi method was validated by 43 experts in policymaking and decision-making. Finally, an practical guideline to deliver bad news to patients and their families was developed with 8 main steps and 43 sub-steps. The main steps included before delivering bad news (assessment, planning and preparation, coordination), during delivering bad news (announcing bad news, emotional support, summary and documentation), and after delivering bad news (referral, follow-up). This practical guideline is intended to facilitate the process of delivering bad news in intensive care units to achieve the desired outcomes and reduce the resulting consequences and harms. Accordingly, healthcare providers are recommended to consider the importance of patient and family preferences, adhering to scientific and standard methods for delivering bad news, and upholding the principles of professional ethics.
Reza Abdollahi, Aynaz Bagherzadi, Mrs Mir Hossein Ahnmadi, Mr Yousef Mohammadpour,
Volume 17, Issue 1 (3-2024)
Abstract
Organizational support is a key factor that may influence and moderate compassion fatigue among nurses. Therefore, this descriptive-analytical study aimed to explore the relationship between organizational support and compassion fatigue in emergency department nurses. The research population consisted of all nurses in the emergency departments of educational hospitals in Urmia, Iran in 2024. A total of 150 nurses were randomly selected based on the inclusion criteria for the study. Data were collected through three questionnaires including a demographic information form, Eisenberger’s Organizational Support Scale, and Figley’s Compassion Fatigue Scale. Data analysis was performed using SPSS software version 15. The results indicated a significant negative relationship between organizational support and compassion fatigue (r=0.45 and p< 0.05). The mean score for organizational support among emergency department nurses was 21.13± 0.54. Moreover, the mean scores for compassion fatigue, compassion satisfaction, and secondary traumatic stress were 27.73 ± 8.54, 38.73 ± 1.81, and 28.45 ± 4.82, respectively. The overall mean score for the nurses' job quality was 31.93 ± 4.32. Given the results of the present study and the role of organizational support in reducing compassion fatigue among nurses, it is crucial for nursing managers and policymakers to take certain measures such as improving working conditions and addressing the needs of nurses to enhance organizational support, consequently helping to reduce and mitigate compassion fatigue among nurses.
Hamidreza Namazi, Navid Ravan,
Volume 17, Issue 1 (3-2024)
Abstract
Medical considerations about aging are as old as medicine itself. However, due to the controversy about whether aging should be classified as a disease or merely a stage of life, geriatric medicine was separated from medicine with a considerable lag. The differentiation of geriatrics from other medical specialties is not rooted in subjecting a specific organ of the body or specific pathophysiological processes but based on a particular stage of life. On the other hand, different stages of life, such as old age, are also subjects for medicalization. Therefore, geriatric medicine may sometimes be threatened by geriatric medicalization and its associated harms. In addition, the relativity and ambiguity in defining the concept of aging and its dependence on social contexts can lead to confusion in understanding the subject matter of geriatric medicine. Mitigating these harms requires philosophical and ethical reflection on health and disease concepts as well as on the essence of aging. Considering that Iran is expected to face an aging crisis in the coming decades, this philosophical reflection at different levels among researchers in the philosophy of medicine and medical ethics, researchers and practitioners in geriatrics, as well as among civil society, can lead to separating geriatric medicine from geriatric medicalization, hence increasing the integrity and efficiency of geriatric medicine, and promoting the health status of the elderly.
Farshid Mohammadmousaei, Zeinab Raiesifar, Seyed Ali Mousavi, Nastaran Khorsandi Bahar, Fatemeh Esmaelzadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Maintaining patient privacy is a fundamental right of patients and an ethical duty of healthcare professionals. The present descriptive, cross-sectional study was conducted in 2022 to compare the perspectives of patients and staff in obstetrics and gynecology operating rooms in Mashhad, Iran, on the extent to which patient privacy was preserved. Patients were selected using random sampling in the operating rooms of hospitals affiliated with Mashhad University of Medical Sciences. Data were collected through a demographic information form and a standardized questionnaire to assess hospitalized patients’ privacy. Data were analyzed via SPSS-22, utilizing descriptive and inferential statistics, with a significance level of P<0.05. The mean ages of patients and staff participating in this study were 39.07±12.56 and 31.65±8.42 years, respectively. The mean score of preserving privacy from the patients' perspective was 38.92±22.41, whereas from the staff's perspective, it was 64.26±8.02, and the difference was statistically significant (p=0.0001). The lowest scores in both groups for personal privacy were 4.97±8.77 for patients and 13.37±2.66 for staff. Results indicated that the staff perceived the level of preserving patient privacy to be above average, while patients considered it below average. Therefore, given the patients’ specific conditions, high stress levels, and physical and mental limitations to support themselves, it is essential to implement targeted training and take necessary measures to encourage the staff to pay more attention to patient privacy and raise patient awareness in this regard.
Mojtaba Parsa, Soudabeh Mehdizadeh,
Volume 18, Issue 1 (3-2025)
Abstract
Domestic violence and abuse against women, particularly intimate partner violence, is a widespread public health problem. Domestic violence is associated with a wide range of physical and mental health issues and negatively impacts the health and well-being of the affected individual. Women who experience violence need support to mitigate the negative impacts of these violent acts. In this regard, health institutions play a critical role in providing comprehensive healthcare to women affected by domestic violence. Physicians' encounters with women experiencing domestic violence, especially in countries like Iran, where there are no clear guidelines on this matter, lead to challenges and ethical issues. This study explored some of these ethical issues and challenges by presenting a case study.
Samira Orujlu, Arezoo Ghavi, Leila Valizadeh, Vahid Zamanzadeh, Sadat Seyed Bagher Maddah, Parvaneh Aghajari,
Volume 18, Issue 1 (3-2025)
Abstract
Improving the quality of nursing services and enhancing ethical decision-making in clinical settings require greater attention to professional ethics. This study aimed to review and synthesize existing research on professional ethics in nursing in Iran, to organize, plan, and establish knowledge- and evidence-based decision-making, and also provide strategies for ethics-centered nursing in Iran. Iranian studies on ethics were reviewed without time limitations until June 22, 2023. Database search was conducted using keywords including "Nurse", "Nursing", "Ethics", "Professional ethics", "Nursing Care", "Codes of Ethics", "Patient Rights", "Conscience", and "Iran", as well as their Persian equivalents, combined with "AND" or "OR" operators. The included studies were analyzed utilizing the five-stage integrative review method proposed by Whittemore and Knafl. A total of 103 Persian and 59 English articles were reviewed. The results were organized into two main categories: achievements of professional ethics (encompassing knowledge, attitudes, and professional performance of nurses; nurses’ experiences with ethical care; positive outcomes of professional nursing ethics education; and the convergence of spiritual health with adherence to professional ethics and the need for an Islamic approach) and factors influencing ethical performance (including facilitators of ethical performance and barriers to adherence to professional ethics). Based on the findings, it is recommended that nursing care protocols and standards be developed, and various educational programs be conducted, including those on ethical care in emergencies and disasters, emotional and spiritual intelligence, training for clinical nursing managers, and the application of creative strategies for teaching clinical professional ethics.
Davood Rasouli, Elham Ramezanpour, Sohrab Nosrati, Akram Zhianifard, Zahra Nouri Khaneghah,
Volume 18, Issue 1 (3-2025)
Abstract
Professional ethics, as a critical aspect of medical ethics, holds significant importance in healthcare professions that directly involve human lives. Accordingly, this study aimed to compare adherence to professional ethics principles among operating room (OR) students and staff in selected teaching hospitals affiliated with Iran University of Medical Sciences during 2021–2022. This cross-sectional descriptive study included 200 OR staff from six hospitals (selected via stratified quota sampling) and 60 OR students (recruited via convenience sampling). Data were collected using a demographic questionnaire and Kadushin’s Professional Ethics Questionnaire (2002) and analyzed in SPSS-24 using descriptive statistics (median and interquartile range) and inferential tests (Chi-square and Mann-Whitney U tests). Results indicated strong professional ethics in 98.4% of students and 75% of staff. Students scored significantly higher in loyalty and accountability (median score, P < 0.0001), while staff outperformed in honesty (median score, P = 0.003). No significant differences were observed in other dimensions. Overall, both groups demonstrated favorable professional ethics. These findings can guide educational interventions and developmental programs to further enhance professional ethics in these populations.
Roya Malekzadeh, Nahid Nickzad Ghadikolaei, Maryam Khazaei-Poul,
Volume 18, Issue 1 (3-2025)
Abstract
Adherence to ethical principles in medical universities, which play a vital role in training the next generation of healthcare professionals, is of significant importance. These principles can serve as a guide to achieving educational goals and improving performance in various academic fields. This study aimed to explain the components of ethics in education at the Mazandaran University of Medical Sciences. The study was conducted in 2023 using a qualitative Hybrid Thematic Analysis approach. Participants included 17 educational managers, faculty members, and students from the university. The study was carried out in three phases: a comprehensive literature review, interviews with experts, and the formation of a specialized panel. Data were collected through semi-structured interviews using purposive and snowball sampling, and the process continued until data saturation was achieved. The interviews were transcribed, coded, classified, and analyzed using thematic analysis. The analysis revealed eight main themes, including ethics, justice, responsibility, duty, respect for others, adherence to dress codes, accountability, and spiritual health, along with 55 subthemes. Focusing on ethical components can enhance transparency, create a fair educational environment, strengthen responsibility among faculty members and students, and improve the quality of learning, thereby playing a crucial role in fostering interactions between professors and students. Adhering to ethical components in academic education not only requires understanding ethical concepts but must also align with appropriate implementation mechanisms. Therefore, organizing training workshops to raise awareness among faculty members, students, and staff, and incorporating ethical indicators into recruitment and promotion processes for faculty members are recommended.
Zahra Khalilzadeh-Farsangi, Samaneh Fallah-Karimi,
Volume 18, Issue 1 (3-2025)
Abstract
With increasing life expectancy and a growing elderly population worldwide, elder care has become a major priority for health systems. These care services are accompanied by numerous ethical challenges, and neglecting them can negatively affect the dignity, rights, and quality of life of older adults. This study aimed to address the question: “What ethical challenges are faced in elder care?” Accordingly, a systematic review was conducted guided by PRISMA guidelines. To identify relevant studies, PubMed, Scopus, Web of Science, SID, and Google Scholar were searched for the period 2013–2025, using the keywords “Ethical Challenges”, “Elderly Care”, “Nursing”, and their Persian equivalents. Inclusion criteria were original articles (qualitative, quantitative, experimental, or quasi-experimental) with a direct focus on ethical challenges in elder care, written in Persian or English, and with full-text availability. Exclusion criteria included letters to the editor and conference abstracts. The quality of the studies was assessed using the appraisal tool proposed by Gifford. In total, 31 eligible articles were included in the final analysis. The results indicated that ethical challenges in elder care can be classified into four main categories, including autonomy, justice, beneficence, and non-maleficence. Subthemes included privacy preservation, shared decision-making, end-of-life care, equitable resource allocation, and the prevention of physical and psychological harm. The findings underscored the necessity of strengthening ethics education and informing policymaking in elder care.
Soudabeh Mehdizadeh, Ehsan Shamsi Gooshki,
Volume 18, Issue 1 (3-2025)
Abstract
The Declaration of Helsinki, as a fundamental document of ethics in medical research involving human participants, has been periodically revised since its adoption in accordance with theoretical and scientific advancements, emerging ethical issues in research, and the experiences gained over time. In the latest revision completed in 2024, significant changes and amendments have been made. This study examined the changes and revisions made in the latest version of the declaration in comparison to its previous version from 2013. Fundamental revisions in the recent update include a requirement for adherence to ethical principles in research not only by physicians but also by other researchers, the replacement of “subject” with “participant,” and the emphasis on the voluntary nature of informed consent. Attention to environmental sustainability, precise design to prevent research waste, and a focus on scientific integrity are among the other amendments in the new revision of this declaration. Other modifications and revisions made in the recent edition include the promotion of individual and public health as the ultimate purpose of research, the provision of sufficient resources for research ethics committees and strengthening their independence, the importance of local ethical review, consideration of the preferences and values of participants who are unable to provide voluntary and informed consent, and the necessity of adhering to the ethical principles of the declaration during public health crises and emergencies. Given the changes made, it is recommended that the national ethical guidelines for medical research involving human participants in Iran be revised based on the 2024 revisions.
Mohsen Shahriari, Maryam Sadat Hashemi, Arash Najimi, Mohammad Zare Reshkoieh,
Volume 18, Issue 1 (3-2025)
Abstract
The fundamental nature of nursing care lies in maintaining patients’ human dignity. Protecting the dignity and high value of humanity is the focus of the nursing profession. This study aimed to compare the effectiveness of mobile application-based and webinar-based professional ethics education on maintaining patient dignity among nursing students. This was a quasi-experimental study with a two-group pretest-posttest design involving 90 undergraduate nursing students. One group received professional ethics education via webinars, while the other received training through a mobile application-based program. Data were collected using a demographic information form and a questionnaire assessing nursing students’ views on maintaining patient dignity. The findings showed that before training, the mean total scores for human dignity were 99.96 ± 17.43 in the webinar group and 99.59 ± 16.28 in the mobile application group, with no statistically significant difference (p=0.62). After training, the mean human dignity score was significantly higher in the mobile application group (111.15±14.69) than in the webinar group (104.34 ± 15.38), and this difference was statistically significant (p=0.02). The findings indicated that professional ethics education delivered via a mobile application was associated with a greater improvement in nursing students’ views on patient dignity compared to webinar-based education. Mobile-based education offers a self-directed, flexible learning method, enabling students to have continuous access to educational content without time or place restrictions. It is recommended that medical universities in Iran consider developing and integrating educational applications into their curricula.
Mohammad Rafiezadeh, Mahshad Noroozi, Akram Hashemi, Saeedeh Saeedi Tehrani,
Volume 18, Issue 1 (3-2025)
Abstract
Physicians often refrain from disclosing their errors for various reasons, including fear of legal claims and the stigma of incompetence. Engaging in professional behavior requires not only adequate knowledge but also a proper attitude toward the behavior in question. Accordingly, understanding physicians’ attitudes is essential for preventing unprofessional conduct under different circumstances. Consequently, the present study aimed to evaluate the attitudes of medical interns toward the disclosure of medical errors at Iran University of Medical Sciences. This descriptive cross-sectional study was conducted among all interns admitted in 2017 at Iran University of Medical Sciences. Data were collected using the Persian version of the Medical Errors Scale and analyzed with SPSS software version 26. Among the 186 participants, 66% reported having committed a medical error. Only 21% of interns fully disclosed errors that had no significant adverse effects on the patient, and the final outcome was favorable. In contrast, in situations where errors resulted in severe consequences for the patient, 31% of participants fully disclosed the error. The findings indicated that most interns avoid fully disclosing their medical errors. Fear of legal action by patients and concerns about being underestimated by them were the two primary reasons reported by participants for nondisclosure of errors. Therefore, further studies are required to propose effective solutions and improve physicians’ performance and patient safety.
Hossein Motaarefi, Shahriar Sakhaei, Amin Soheili, Hassan Ebrahimpour Sadagheyani,
Volume 18, Issue 1 (3-2025)
Abstract
Patients’ perceptions of healthcare service quality and satisfaction with their legal rights constitute the primary objective of the care team and should be considered a criterion for accreditation evaluation. In this regard, a thorough examination of healthcare providers’ and patients’ perceptions, emotions, and experiences regarding the reasons for ‘Discharge Against Medical Advice’—as a patient’s legal right—can help identify hidden factors influenced by temporal and spatial conditions. This qualitative study employed a conventional content analysis approach, involving semi-structured interviews with 24 healthcare providers and patients selected purposively. Researchers repeatedly reviewed recorded content and notes to code the data. Subsequently, key codes and themes were clustered, categorized into specific topics, and labeled. Finally, an interpretation of the obtained data reflecting the study’s approach was presented. Through conventional content analysis, 203 codes were extracted. After categorization, four subthemes, including human factors, processes, facilities, and environment, were identified under the core theme of “uncertainty and distrust” as reasons for discharge against medical advice. Discharge against medical advice is recognized as both a challenge for hospital accreditation and an adverse outcome for patients. Addressing uncertainty-related issues and fostering public trust through team collaboration and implementing novel policies can mitigate discharge against medical advice.
