Ethical challenges in medical error disclosure among healthcare professionals in teaching hospitals: a qualitative study.
- 1Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran.
- 2School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran. [email protected].
- 3Clinical Research Center, Pasteur Educational Hospital, Bam University of Medical Sciences, Bam, Iran.
Abstract
Background
Medical error disclosure is a fundamental component of patient safety and professional ethics in healthcare systems; however, in practice, it is frequently influenced by individual, organizational, and contextual factors. Although international research has examined issues such as blame culture and psychological safety, an in-depth qualitative understanding of the ethical challenges surrounding medical error disclosure in Iranian teaching hospitals remains limited.Purpose
This study aimed to explore the ethical challenges of medical error disclosure among healthcare professionals working in Iranian teaching hospitals.Methods
This qualitative study using an inductive qualitative content analysis approach was conducted in 2025 in teaching hospitals affiliated with Bam University of Medical Sciences. Sixteen healthcare professionals were selected through purposive sampling with maximum variation. Data were collected through in-depth semi-structured interviews and analyzed concurrently using the qualitative content analysis approach of Graneheim and Lundman.Findings
Data analysis yielded five main themes and 20 categories: conflict between ethical commitment to honesty and perceived organizational insecurity; blame-oriented organizational responses and the suppression of learning; selective concealment and informal management of errors as protective responses; psychological and moral burden following error experiences; and structural and relational conditions shaping error disclosure. Overall, participants described error disclosure as a context-dependent ethical process shaped by the interaction of professional commitment, organizational insecurity, managerial responses, and broader structural conditions.Conclusion
Medical error disclosure emerged as a complex, context-dependent ethical process embedded within organizational and relational contexts rather than an isolated individual decision. The findings highlight the importance of fostering Just Culture and psychological safety to support transparent error disclosure and organizational learning in Iranian teaching hospitals.
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BibTeX
@article{fuladvandi2026ethical,
title = {{Ethical challenges in medical error disclosure among healthcare professionals in teaching hospitals: a qualitative study.}},
author = {Masoumeh Fuladvandi and Leila Malekyan and Parvane Hamidian},
journal = {BMC nursing},
year = {2026},
month = aug,
doi = {10.1186/s12912-026-05257-9},
url = {https://europepmc.org/article/MED/42850605},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Ethical challenges in medical error disclosure among healthcare professionals in teaching hospitals: a qualitative study.
AU - Masoumeh Fuladvandi
AU - Leila Malekyan
AU - Parvane Hamidian
PY - 2026
DA - 2026/08/27
JO - BMC nursing
DO - 10.1186/s12912-026-05257-9
UR - https://europepmc.org/article/MED/42850605
AB - Background Medical error disclosure is a fundamental component of patient safety and professional ethics in healthcare systems; however, in practice, it is frequently influenced by individual, organizational, and contextual factors. Although international research has examined issues such as blame culture and psychological safety, an in-depth qualitative understanding of the ethical challenges surrounding medical error disclosure in Iranian teaching hospitals remains limited.Purpose This study aimed to explore the ethical challenges of medical error disclosure among healthcare professionals working in Iranian teaching hospitals.Methods This qualitative study using an inductive qualitative content analysis approach was conducted in 2025 in teaching hospitals affiliated with Bam University of Medical Sciences. Sixteen healthcare professionals were selected through purposive sampling with maximum variation. Data were collected through in-depth semi-structured interviews and analyzed concurrently using the qualitative content analysis approach of Graneheim and Lundman.Findings Data analysis yielded five main themes and 20 categories: conflict between ethical commitment to honesty and perceived organizational insecurity; blame-oriented organizational responses and the suppression of learning; selective concealment and informal management of errors as protective responses; psychological and moral burden following error experiences; and structural and relational conditions shaping error disclosure. Overall, participants described error disclosure as a context-dependent ethical process shaped by the interaction of professional commitment, organizational insecurity, managerial responses, and broader structural conditions.Conclusion Medical error disclosure emerged as a complex, context-dependent ethical process embedded within organizational and relational contexts rather than an isolated individual decision. The findings highlight the importance of fostering Just Culture and psychological safety to support transparent error disclosure and organizational learning in Iranian teaching hospitals.
SN - 1472-6955
ER -