Evidence map›Paper›PMID 41469647›Full record

ArticleBMC medical ethics2025

Legal and ethical conflicts in hospital settings: thematic synthesis of qualitative studies focused on nursing practice.

Sajad Yarahmadi, Tayebeh Cheraghian, Setare Jafarifar

Abstract read
In one paragraph

Article in BMC medical ethics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Sajad YarahmadiSocial Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran. S.Yarahmadi000@gmail.com.
Tayebeh CheraghianCardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran. cheraghiantayebe@gmail.com.
Setare JafarifarStudent of Nursing, Young Researchers Club, Islamic Azad University of Khorramabad, Khorramabad, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe conflict between legal requirements and the principles of care ethics is one of the fundamental challenges in healthcare settings. Such conflicts can lead to moral distress, emotional exhaustion, and a crisis of professional identity among healthcare staff. This study aimed to identify and explain the dimensions and consequences of these conflicts in a hospital nursing care.

methodsThis research employed thematic synthesis of qualitative studies. A systematic search was conducted in reputable national and international databases for studies published between 2010 and 2025. Of the retrieved literature, 15 qualitative studies were included that examined legal-ethical conflicts in hospital settings. Data were synthesized through open coding, axial categorization, and the development of analytical themes.

resultsFour overarching themes and twelve subthemes emerged: (1) Patient autonomy versus legal protection, (2) Organizational directives and resource allocation versus moral duty of care, (3) Defensive documentation versus ethical transparency, and (4) Hierarchy, inequality, and professional silence versus justice and integrity. These tensions frequently led to moral distress, erosion of professional identity, and emotional strain among healthcare professionals.

conclusionLegal-ethical conflicts deeply affect both caregivers and institutional cultures. Mitigating their impact requires coordinated reforms: integrating ethics education and decision-making training into nursing curricula, revising legal frameworks to allow greater contextual flexibility, and establishing psychosocial and ethical support systems for staff exposed to recurring moral tensions. Such multi-level strategies can bridge the gap between law and moral care, fostering ethical coherence, professional sustainability, and trust within healthcare systems.

Indexed as

Conflict, PsychologicalEthics, NursingHospitalsHumansMoral ObligationsOrganizational CultureQualitative ResearchEthical decision-makingHospital careLegal–ethical conflictMoral distressNursing ethicsProfessional identity

Identifiers

PMID41469647
PMCPMC12755018

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.