BMC Medical Ethics最新文献

{"title":"\"No, it is not a breach of my oath because it is beyond my control; I use the policies that are in place.\" Ethical challenges faced by healthcare workers in the provision of healthcare to cross-border migrants in Botswana.","authors":"Galekgatlhe Bailey Balekang, Treasa Galvin, Daniel Serai Rakgoasi","doi":"10.1186/s12910-025-01195-4","DOIUrl":"10.1186/s12910-025-01195-4","url":null,"abstract":"<p><strong>Background: </strong>With a growing global population of migrants, understanding the complex dynamics between healthcare providers and policy restrictions is crucial for ensuring equitable access to healthcare. The main objective of this qualitative study was to explore the ethical challenges faced by health care providers in the provision of health care to migrants.</p><p><strong>Methods: </strong>We conducted in -depth interviews with 11 healthcare providers, which were analysed using thematic analyse. Atlas ti software was used to analysis the data.</p><p><strong>Results: </strong>Healthcare workers reported facing ethical challenges as a result of not being able to provide medical care to migrant patients because healthcare policies deny them access to healthcare. These policies make it difficult for healthcare professionals to fulfil their duties in accordance with their oath. Failure to provide healthcare to migrant patients can cause moral distress for healthcare workers and affect their well-being. Reporting migrant patients to the police was mentioned as another ethical challenge, which is a breach of confidentiality. Several healthcare providers have developed strategies to address the limitations of migrants' access to healthcare, including encouraging migrants to access healthcare from their home country and using private healthcare facilities.</p><p><strong>Conclusions: </strong>Health policies influence the way health care providers carry out their tasks, which can either positively or negatively impact access for vulnerable migrant groups. To address the challenges faced by healthcare providers in implementing their professional ethics, inclusive policies should be introduced, and human rights and ethics training should be provided, as well as ongoing dialogue to ensure that healthcare providers fulfil their professional obligations toward all migrant patients.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"34"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the surgical informed consent for elective and emergency surgeries in obstetrics and gynaecology in Saudi Arabia.","authors":"Maryam Al-Meshkhas, Zahraa Alakrawi, Sumaiah Alrawiai","doi":"10.1186/s12910-024-01159-0","DOIUrl":"10.1186/s12910-024-01159-0","url":null,"abstract":"<p><strong>Background: </strong>Informed consent (IC) represents one of the fundamental rights of patients in healthcare. An essential aspect of the IC process is providing patients with equal access to information to enable them to make the right decisions. However, failure to obtain IC undermines patient autonomy, lowers patient satisfaction, increases risks, and negatively affects the patient's trust in healthcare providers. This study aims to evaluate the surgical informed consent (SIC) process from the patient's perspective both for emergency and elective surgeries in obstetrics/genecology in Saudi Arabia.</p><p><strong>Methods: </strong>This is a quantitative cross-sectional study. The study population included all hospitalized female patients who had undergone obstetric or gynaecological surgeries, from February 2021 to March 2021. The total sample size was 156 female patients.</p><p><strong>Results: </strong>Most of the participants were married (96.2%) and unemployed (80.1%). The most performed surgery was caesarean Sect. (84%). Most of the patients were satisfied with their SIC experience which represents over 85%. No significant difference has been found between the elective and emergency surgeries. However, person-in-charge of SIC administration and the time provided to sign the IC were deemed to be significant predictors.</p><p><strong>Conclusion: </strong>Based on the findings, it is recommended that physician take responsibility for the SIC administration rather than an unknown provider. It is also recommended to provide the patients with adequate time to understand the SIC. Furthermore, ensuring the availability of emotional support is critical for enhancing the patient experience.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"33"},"PeriodicalIF":3.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing obstetricians' acceptance of termination of pregnancy beyond the first trimester: a qualitative study.","authors":"Fien De Meyer, Kenneth Chambaere, Sarah Van de Velde, Kristof Van Assche, Kim Beernaert, Sigrid Sterckx","doi":"10.1186/s12910-025-01186-5","DOIUrl":"10.1186/s12910-025-01186-5","url":null,"abstract":"<p><strong>Background: </strong>In Belgium, termination of pregnancy after the first trimester is exclusively allowed on medical grounds. When faced with fetal or maternal health complications during pregnancy, patients typically turn to obstetricians for guidance on the diagnosis, prognosis, and available options. Patients' decisions and their actual access to termination of pregnancy can be profoundly influenced by the quality of this counselling and the willingness of professionals to present termination as an acceptable option. This paper aims to explore the factors influencing obstetricians' acceptance of TOP requests after the first trimester of pregnancy. We subsequently analyze these acceptance dynamics from a multidisciplinary angle, incorporating ethical perspectives and a socio-legal exploration into how the interviewed health professionals experience, interpret, and apply the law.</p><p><strong>Methods: </strong>We conducted an interview study with 23 hospital obstetricians who had prior experience with termination of pregnancy decision-making beyond the first trimester in Flanders, Belgium. Interviews, on average, lasted 1h30 and followed a semi-structured format guided by a topic guide. The transcripts were coded with NVivo software and subsequently thematically analyzed by a multidisciplinary research team to provide a comprehensive understanding of obstetricians' acceptance of termination of pregnancy after the first trimester.</p><p><strong>Results: </strong>Obstetricians' acceptance of termination of pregnancy after the first trimester mainly depends on the presence of compelling clinical factors. Secondary factors, including patient/couple preferences, institutional and collegial processes, timing and viability, technical considerations, obstetricians' ethical and professional values, the wider background of the patient/couple, and perception of alternatives, could sway decisions in the absence of compelling clinical factors.</p><p><strong>Conclusions: </strong>Secondary factors help sway obstetricians' decisions in favor of or against termination of pregnancy after 12 weeks when a request is characterized by inconclusive clinical factors. The multifactorial acceptance dynamics of obstetricians illustrate the limits of a strong emphasis on fetal interest argumentation. Moreover, they exhibit a degree of divergence and complexity absent from the Belgian Abortion Law. The presented typology of factors could stimulate and guide debates on legal reform and the importance that should be attributed to various factors in professional decision-making on termination of pregnancy.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"32"},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress among maternal-fetal medicine fellows: a national survey study.","authors":"Jia Jennifer Ding, Thi Vu, Suzanne Stammler, Peter Murray, Elizabeth Epstein, Sarah N Cross","doi":"10.1186/s12910-025-01187-4","DOIUrl":"10.1186/s12910-025-01187-4","url":null,"abstract":"<p><strong>Background: </strong>Moral distress, or the inability to carry out what one believes to be ethically appropriate because of constraints or barriers, is understudied in obstetrics and gynecology. We sought to characterize moral distress among Maternal-Fetal Medicine (MFM) fellows using a standardized survey.</p><p><strong>Methods: </strong>We disseminated a national anonymized survey study of MFM fellows electronically regarding moral distress using a validated questionnaire with supplemental questions pertaining to specific challenges within MFM clinical care. Multivariable linear regression modeling was used to examine the association between abortion restrictions, maternal mortality, and moral distress, controlling for demographic variables. Thematic analysis was performed for the free text responses elaborating upon moral distress and grouped by thematic elements. We hypothesized that training in states with more abortion restrictions and higher maternal mortality would be associated with higher moral distress scores.</p><p><strong>Results: </strong>Among 245 total responses (61% response rate), 177 complete responses (44% complete response rate) were included for analysis. Most of our respondents identified as female (78.5%), White (71.8%), and training in urban programs (83.1%). 37.9% of respondents reported training in the Northeast, with the remainder of respondents evenly distributed across the United States. The mean score for the validated questions was 85.9 ± 48.8, with female gender identity associated with higher measures of moral distress on the validated portion of the questionnaire as compared to male gender identity (90.1 ± 49.2 vs. 70.4 ± 44.7, p < 0.05), whereas more advanced training was associated with higher measures of moral distress on the supplemental questions as compared to those less advanced in training (20.9 ± 11.8 vs. 28.5 ± 15.9 vs. 25.9 ± 15.6 for PGY-5 vs. PGY-6 vs. PGY-7 and PGY-8 combined, respectively, p < 0.05). After adjustment, higher measure of moral distress on the validated questionnaire was associated with training in states designated \"Abortion restrictive\" as compared to \"Abortion most protective\" (beta estimate 27.80 and p < 0.01). Of 34 free responses, 65% referred to limitations on abortion access and reproductive justice as causes of significant moral distress.</p><p><strong>Conclusion: </strong>MFM fellows who identify as female reported higher measures of moral distress, as well as those training in states with more abortion restrictions. Among free text respondents, abortion restrictions underlie a significant proportion of moral distress.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"31"},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Evaluating the understanding of the ethical and moral challenges of Big Data and AI among Jordanian medical students, physicians in training, and senior practitioners: a cross-sectional study.","authors":"Abdallah Al-Ani, Abdallah Rayyan, Ahmad Maswadeh, Hala Sultan, Ahmed Alhammouri, Hadeel Asfour, Tariq Alrawajih, Sarah Al Sharie, Fahed Al Karmi, Ahmed Mahmoud Al-Azzam, Asem Mansour, Maysa Al-Hussaini","doi":"10.1186/s12910-025-01184-7","DOIUrl":"10.1186/s12910-025-01184-7","url":null,"abstract":"","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"30"},"PeriodicalIF":3.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of scientific research integrity knowledge in dental undergraduates from 34 universities in China.","authors":"Xiaojin Wu, Tongxin Zheng, Yufei Nie, Jingyi Wu, Jirong Chen, Janak L Pathak, Lihong Wu","doi":"10.1186/s12910-025-01183-8","DOIUrl":"10.1186/s12910-025-01183-8","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the status of research integrity knowledge among dental undergraduates from 34 Chinese universities in 5 key demographic regions.</p><p><strong>Methods: </strong>Questionnaires regarding the status of research integrity, including perception, attitude, and firsthand experience of scientific research integrity, were distributed to dental undergraduates of 34 Chinese universities. These universities were from 5 key demographic regions of China, i.e., eastern, western, northern, southern, and central. The questionnaires filled out by 1514 participants were further analyzed.</p><p><strong>Results: </strong>The results showed that among the participants, nearly 70% acquire scientific integrity knowledge through courses, as well as ideological and political education, while the remaining students acquire scientific integrity knowledge through other means, such as books and conferences. From the attitude perspective, most students (80-90%) oppose scientific misconduct. However, a few students also have an insufficient understanding of scientific misconduct and still need to improve their scientific research integrity training further. We also found that the research integrity training and the surrounding research environment affect students' attitudes and self-behavior regarding scientific integrity.</p><p><strong>Conclusion: </strong>Our findings indicate that the ethical academic and research environment, implementation of scientific integrity courses in the curriculum, and proper supervision are vital in improving scientific research integrity knowledge in dental undergraduates in Chinese universities.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"29"},"PeriodicalIF":3.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of healthcare professionals' perceived occupational stigma on organizational citizenship behavior: a moral cleansing perspective.","authors":"Ganli Liao, Jianfeng Liu, Yi Li, Hongyi Ye, Jiayi Liang","doi":"10.1186/s12910-025-01185-6","DOIUrl":"10.1186/s12910-025-01185-6","url":null,"abstract":"<p><strong>Background: </strong>Occupational stigmatization in Chinese healthcare institutions has intensified due to negative public events (e.g., kickbacks, bribes, and patient conflicts). While previous studies have mainly focused on the negative effects of stigma on practitioners' physiological and psychological states of practitioners with low prestige, little attention has been given to the moral psychological mechanisms involved or the potential positive outcomes. This study aims to explore the moral mechanisms of healthcare professionals' perceived occupational stigma on organizational citizenship behavior (OCB), with a specific focus on the potential effects of moral credibility loss, moral sensitivity, and occupational prestige.</p><p><strong>Methods: </strong>This study employed a hierarchical regression method to test the theoretical model, using data from 554 healthcare professionals (including 311 physicians and 243 nurses) from 7 hospitals in China. Confirmatory factor analysis, hierarchical regression, bootstrapping analysis (= 5000 times) and simple slope test using SPSS and AMOS were employed.</p><p><strong>Results: </strong>The empirical results demonstrate that healthcare professionals' occupational stigma enhances OCB by increasing moral credibility loss, with moral sensitivity playing a moderating role. Additionally, this study categorizes healthcare professionals into two groups based on occupational prestige: physicians (high occupational prestige) and nurses (relatively lower occupational prestige). The findings indicate that occupational prestige not only moderates the positive relationship between occupational stigma and moral credibility loss but also moderates the relationship between moral credibility loss and OCB.</p><p><strong>Conclusions: </strong>This study comprehensively explores healthcare professionals' occupational stigma and reveals its positive moral effects, specifically in enhancing OCB through the moral cleansing perspective. These findings offer a novel understanding of occupational stigma, providing practical guidance for improving professional ethics and OCB.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"28"},"PeriodicalIF":3.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent and parental proxy online record access: analysis of the empirical evidence based on four bioethical principles.","authors":"Josefin Hagström, Maria Hägglund, Charlotte Blease","doi":"10.1186/s12910-025-01182-9","DOIUrl":"10.1186/s12910-025-01182-9","url":null,"abstract":"<p><strong>Background: </strong>During recent decades, providing patients with access to their electronic health records (EHRs) has advanced in healthcare. In the European Union (EU), the General Data Protection Regulation provides individuals with the right to check their data in registries such as EHRs. A proposal for a European Health Data Space has been launched, which will further strengthen patients' right to have online access to their EHRs throughout Europe. Against these policy changes, scant attention has been paid to the ethical question about whether adolescents and parents should access the adolescent's EHR, and if so, under what conditions.</p><p><strong>Methods: </strong>In this paper, we apply biomedical ethical principles to explore key questions about adolescents' and parents' access to adolescents' EHRs, with the aim of informing future discussions about the development of ethical and policy practice guidelines.</p><p><strong>Results: </strong>Drawing on current empirical research, we find preliminary evidence that in some contexts, patient online record access (ORA) could help to facilitate autonomy for adolescents and parents as well as offering support in managing appointments and medications. Notably, however, we find contrasting perspectives between adolescents' and parents' experienced benefits and healthcare professionals' (HCPs) perceived potential harm, with the latter worried about decreased documentation quality after access. Concerns about capacity to understand their health information, and increased anxiety among adolescents obstruct the support of adolescent autonomy among parents and HCPs. Still, research is limited, particularly with respect to adolescents' experiences of reading their EHRs, and differences across settings have not been closely examined.</p><p><strong>Conclusions: </strong>To advance more comprehensive understanding of the effects of ORA, and to inspire greater attention to, and development of, evidence-informed ethical guidance in this domain of clinical practice, we outline a range of empirical questions regarding adolescents' and parents' experiences that now warrant further study.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"27"},"PeriodicalIF":3.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Researchers' Perspectives on Institutional Review Boards Functions in Saudi Arabia: A Survey Utilizing the IRB-RAT Tool.","authors":"Areej AlFattani, Asma AlShahrani, Norah AlBedah, Ammar Alkawi, Amani AlMeharish, Yasmin Altwaijri, Abeer Omar, M Zuheir AlKawi, Asim Khogeer","doi":"10.1186/s12910-025-01179-4","DOIUrl":"10.1186/s12910-025-01179-4","url":null,"abstract":"<p><strong>Background: </strong>The ethics committee has the responsibility to comply with the rules and guidelines regarding oversight of all human research activities, particularly when the research study involves vulnerable people. It also has the role of educating researchers on ethical issues, scientific truthfulness, preventing misconduct and conflicts of interest. In our study we evaluate and benchmark the function of the local ethical committees across the country from the researchers point-of-view.</p><p><strong>Methods: </strong>We employed an online IRB-RAT survey to measure perspectives of investigators towards IRB functions dealing with fairness issues, services, bias, and competences and upholding the rights of the human participants. Two responses were recorded: first shows how important an IRB function is for the investigator in his work, second shows how researchers rate their IRBs in being descriptive in that specific function. The difference of these two scores represent the outcome.</p><p><strong>Results: </strong>We had 179 participants, 166(94%) researchers/research coordinators, and 13(7.2%) IRB members, 94 (53%) participants had been working in the research field for more than 11 years, and the majority 163(90%) revealed that they had IRB contact. The largest gap between actual rating and ideal was observed for the item \"An IRB that requires that its chair be an experienced investigator\" with a score difference of 1.53. In contrast, the smallest score difference was for the item \"Considering the protection of human participants,\" which had a score of 0.51.</p><p><strong>Conclusion: </strong>According's to researchers point of view; IRBs respect researchers, view human protections as a primary role, do not allow personal bias, maintain accurate records and take timely action whenever misconduct is reported. Further collaborations are needed to enhance IRB performance and to engage researchers in more productive communication with their IRBs.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"26"},"PeriodicalIF":3.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical issues in unprofessional behavior of residents who dispute dismissal: ten year analysis of case law in hospital-based specialties.","authors":"Judith Godschalx-Dekker, Sebastiaan Pronk, Gert Olthuis, Rankie Ten Hoopen, Walther van Mook","doi":"10.1186/s12910-025-01180-x","DOIUrl":"10.1186/s12910-025-01180-x","url":null,"abstract":"<p><strong>Background: </strong>Residents who do not internalize professional values may not be a good fit for their specialty and compromise the quality of their patient care. Research aimed at recognizing residents' shortcomings in professionalism may help to prevent future shortcomings towards patients. The aim of this study was to increase insight into residents' shortcomings in medical professionalism in light of professional values relevant within residency training.</p><p><strong>Methods: </strong>We analyzed all law cases from the Dutch national conciliation board from 2011 to 2020 on the unprofessional behaviors described.</p><p><strong>Results: </strong>During the period investigated, 61 dismissed residents challenged their dismissal. In 39 of 61 cases (64%), the program director named unprofessional behavior(s) as (one of the) reasons for dismissal. The most prevalent deficit of residents deemed unprofessional was poor self-awareness (80%); less prevalent deficits were: shortness of engagement and dishonest and disrespectful behavior (31% or less).</p><p><strong>Conclusions: </strong>We describe perceived unprofessional behavior in residency, which was not about exceptional or abominable behaviors. For the most part, these behaviors concerned the accumulation of remediation-resistant day-to-day underperformance, discrediting trust and professional reliability. This finding encourages dedicated longitudinal assessment of professionalism and fuels the ethical debate about required professional values in hospital care.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"25"},"PeriodicalIF":3.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}