Abstract
Physicians try hard to alleviate mental and physical ailments of their patients. Thus, they are heavily burdened by observing ethics and staying well-informed while improving health of their patients. A major ethical concern or dilemma in medication is that some physicians know their behavior is unethical, yet act against their moral compass. This study develops models of theory–practice gap, offering optimal solutions for the gap. These solutions would enhance self-motivation or remove external obstacles to stimulate ethical practices in medicine. The Constructivist Grounded Theory Methodology is applied here where the participants and the main researcher mutually interacted with each other. Data collection was performed through qualitative methods including observation and semi-structured interviews with 21 physicians and medical students. Initial and focused coding was done, from which principal concepts were later extracted. MAXQDA software was used for analyzing data. Analysis of twelve major concepts in the study resulted in two factors and solution groups, from which four general notions influencing the ethical theory and practice gap in medicine were extracted: (1) providing effective education to change attitude and behavior; (2) considering motivational and emotional factors; (3) reconstructing regulations and processes to facilitate ethical practice; (4) conducting comprehensive and systematic studies. The existing medical educational system needs to be reconsidered to add to individual internal motivation, including optimizing persuasion strategies, maximizing participation of students, adhering to virtuous ethical theories, and fostering emotions. Additionally, regulations and processes can be reconstructed to remove practical obstacles and promote ethical practice with insignificant damages to individual self-motivation.
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Notes
As Richard Holton, Professor of Philosophy at the University of Cambridge, explained, akrasia, as Aristotle does, is a gap between moral belief and action. However, he believes that a weak-willed person breaks his resolution readily and leaves right action. Thus, he explains weakness of will according to one’s intention and akrasia according to one’s bad desires.
Structuralist sociologists and behavioral psychologists.
Ethical ignorance is important and reflects poor education, but is not in the realm of the present study.
A philosopher of Greece and the founder of the Academy (the first institution of higher learning in the Western world.).
An Iranian Shia philosopher (1571–1636), and the most significant Islamic philosopher after Avicenna, who attempted to transcend the simple dichotomy between a discursive, ratiocinative mode of reasoning and knowing, and a more intuitive, poetic and mystical mode of knowledge (https://plato.stanford.edu/entries/mulla-sadra/).
One of the Iranian philosophers, renowned scholars, and thinkers of the eleventh century.
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Madani, M., Vedadhir, A., Larijani, B. et al. Bridging the Gap Between Ethical Theory and Practice in Medicine: A Constructivist Grounded Theory Study. Sci Eng Ethics 26, 2255–2275 (2020). https://doi.org/10.1007/s11948-020-00217-1
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DOI: https://doi.org/10.1007/s11948-020-00217-1