Ethical Challenges Experienced by Physicians and Nurses in Caring for Patients with COVID-19: A Qualitative Study

Background: Emerging COVID-19 pandemic has posed numerous ethical challenges to frontline healthcare professionals. Objectives: This study aimed to explain the ethical challenges experienced by physicians and nurses in caring for COVID-19 patients during the early phases of the pandemic. Methods: This qualitative study was conducted using by content analysis approach. Twenty-two semi-structured in-depth interviews were conducted with 18 physicians and nurses working in medical centers and hospitals of the public or private sectors, in Tehran, the capital of Iran, from July to October 2020. The Graneheim and Lundman approach was applied to analyze the data. MAXQDA 10 software was used to facilitate the data analysis process. Results: The ethical challenges are categorized into four categories (and 11 subcategories), including poor professional care, preference for public interests over individual care, difficult decision-making, and moral distress. Most participants experienced poor professional care, non-compassionate care, lack of family-centered care, being forced to choose, lack of emotional and anger control and coping skills, an undermined ethical climate, and emotional fatigue during the early phases of the pandemic. Conclusions: The findings indicate the attenuation of professional care and the need to develop evidence-based ethical and clinical guidelines concerning the resulting insights. In addition, devising appropriate interventions is recommended for their psycho-emotional support.