Evaluation of physicians' perceptions of fear of medical error and the role of ethical climate in defensive medicine practices by vignette technique

Title: Evaluation of Physicians' Perceptions of the Role of Ethical Climate in Fear of Medical Errors and Defensive Medicine Practices Using the Vignette Technique Objective: Ethical climate is considered a significant antecedent of unethical behavior. Research on the relationship between ethical climate and the occurrence of medical errors is insufficient. In this thesis research, physicians' perceptions of the role of ethical climate in their fear of medical errors and defensive medicine practices were evaluated. Method: A phenomenological approach, one of the qualitative research methods, was used in the study. The population of the research consisted of surgeons working in two public hospitals located in the city center of Eskişehir, and the sample comprised 23 participants. Semi-structured questions related to the definitions of concepts and five case vignettes were asked to assess the physicians' perceptions of the ethical climate. A data analysis software package used in qualitative research was utilized for the statistical analysis of the data. Findings: Physicians experienced confusion in defining concepts. Some physicians were unable to define defensive medicine. Almost all physicians experienced fear of malpractice. Although most physicians did not find defensive medicine practices ethical, they experienced ethical dilemmas in their professional practices. Physicians' perceptions of the role of ethical climate in their fear of malpractice and defensive medicine practices were evaluated under the themes of "team members and teamwork," "colleagues' attitudes," "patients and their relatives," "administrators," "regulations and legal processes," and "defensive medicine practices." Results: Physicians generally have a negative perception of the ethical climate, particularly concerning the theme of "legislation and legal processes." Almost all physicians engage in defensive medicine. Minimizing medical errors, the fear of malpractice, and defensive medicine, as well as implementing necessary regulations and measures to enhance patient safety, employee and patient satisfaction, are crucial for establishing a positive ethical climate.