ArticleBMC health services research2025
Culture of paternalism in the emergency department: a critical ethnographic study.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ceiling of Care in Acute Care Settings: A Concept Analysis.Journal of nursing management · 2026Pooled it
- Reengineering the Concept of Emergency Care.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Patient-reported gaps in use and quality of informed consent practices in dental care in Saudi Arabia: a regional cross-sectional survey.BMC oral health · 2026Article
- Health responsibility among marginalized women in Mashhad, northeastern Iran: a critical ethnographic study.International journal for equity in health · 2026Article
- Health-promoting lifestyles among suburban women: A critical ethnographic study protocol.PloS one · 2026Article
- Detecting Sociodemographic Biases in the Content and Quality of Large Language Model-Generated Nursing Care: Cross-Sectional Simulation Study.Journal of medical Internet research · 2025Article
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Authors and funding
5 authors.
Funding
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Abstract
backgroundPaternalism refers to the act of overriding an individual's preferences or decisions under the justification of acting in their best interest or protecting them from harm. When paternalistic care is delivered, it can result in adverse physical, psychological, and social consequences for patients. This study aimed to describe, interpret, and critically examine the culture of paternalism within the context of the emergency department.
methodsThis critical ethnographic study was conducted in the emergency department of a public hospital in Khorasan Razavi Province, Iran. The research followed Carspecken's method of critical ethnography, encompassing three preliminary and five main stages. Data were collected through participant observation, in-depth interviews, and document analysis to uncover the beliefs, values, actions, and power dynamics that reinforce paternalistic structures within the emergency care setting. Over 22 months of field work, empirical data were gathered and subsequently analyzed using reconstructive analysis. The identified systemic relationships were then interpreted in light of relevant sociological theories.
resultsAnalysis of the data led to the identification of four categories: domination of the superior, facilitation of the domination of the superior, destruction of the inferior, and the echoes of paternalism.
conclusionsThe findings indicate the presence of an entrenched culture of paternalism in the emergency department-one that poses significant challenges to delivering humane and ethically grounded patient care. These results underscore the need to raise awareness among healthcare providers regarding the ethical dimensions of clinical interactions and to enhance their understanding of the social and legal issues related to patient care. Ultimately, such awareness can inform strategies to recognize and address structural barriers, promote respect for patient autonomy, and support adherence to patients' rights.
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