Mrs Negar Ahmadi2, Mr Mostafa Moghimi2, Dr Mohammad Hossein Eftekhari2, Dr Alireza Parsapour2, Dr Ayat Ahmadi3, Dr Neda Yavari4, Professor Bagher Larijani2, Dr Ehsan Shamsi Gooshki1,2
1Monash Bioethics Center, Monash University, Melbourne, Australia, 2Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran, 3Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran, Tehran, Iran, 4School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Biography:
Dr. Ehsan Shamsi Gooshki is a certified physician (M.D.) and a bioethicist (Ph.D.). For 15 years, he has been actively involved in teaching various undergraduate and post-graduate educational programs and conducting extensive research in diverse fields of bioethics, including research ethics, clinical ethics, public health ethics, and bioethics governance.
Abstract:
Defensive medicine is considered one of the challenging phenomena in contemporary medicine. Many definitions of defensive medicine have been proposed, the common point of all of which is the presence of a kind of self-defense motivation in physicians when they feel or understand the existence of an external threat related to professional activity, leading to taking measures to eliminate or manage threats. Hence, defensive medicine involves actions by physicians with no medical indication or benefit for patients (positive defensive medicine) and/or avoiding risky actions with medical indication and benefit for patients (negative defensive medicine), solely to protect themselves against legal complaints or tensions, such as aggression or blame from patients, companions, or colleagues. Defensive practices may cause physical, mental, or economic damage to patients, families, or even the organizations that pay for the treatment, such as insurance companies. Defensive medicine is a challenging ethical and legal phenomenon in contemporary medicine. Developing reliable tools to evaluate physicians’ attitudes and practices in this area can play a significant role in managing this phenomenon.
To evaluate this phenomenon, a questionnaire consisting of 67 questions, developed and validated based on an extensive literature review and a qualitative study, was sent to physicians registered with the Iran Medical Council. More than 3,200 physicians responded to this questionnaire. The results show a high prevalence of defensive behaviors among physicians practicing in Iran, with variability between different specialties and fields of practice.
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