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Background The use of artificial intelligence (AI) is not a recent phenomenon, but the latest advancements in this technology are making a significant impact across various fields of human knowledge. In medicine, this trend is no different, although it has developed at a slower pace. ChatGPT is an example of an AI-based algorithm capable of answering questions, interpreting phrases, and synthesizing complex information, potentially aiding and even replacing humans in various areas of social interest. Some studies have compared its performance in solving medical knowledge exams with medical students and professionals to verify AI accuracy. This study aimed to measure the performance of ChatGPT in answering questions from the Progress Test from 2021 to 2023. Methodology An observational study was conducted in which questions from the 2021 Progress Test and the regional tests (Southern Institutional Pedagogical Support Center II) of 2022 and 2023 were presented to ChatGPT 3.5. The results obtained were compared with the scores of first- to sixth-year medical students from over 120 Brazilian universities. All questions were presented sequentially, without any modification to their structure. After each question was presented, the platform's history was cleared, and the site was restarted. Results The platform achieved an average accuracy rate in 2021, 2022, and 2023 of 69.7%, 68.3%, and 67.2%, respectively, surpassing students from all medical years in the three tests evaluated, reinforcing findings in the current literature. The subject with the best score for the AI was Public Health, with a mean grade of 77.8%. Conclusions ChatGPT demonstrated the ability to answer medical questions with higher accuracy than humans, including students from the last year of medical school.

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Background: With the increasing ethical challenges and dilemmas faced by nurses due to various disasters such as COVID-19 worldwide, there is a need for a new public health ethics education curriculum to strengthen competencies for ethical responses in the nursing field. Objectives: This study was aimed to identify the impact of a teaching method utilizing news articles and panel discussion material in the public health ethics education program on nursing students' thinking regarding ethical issues. Design: This was an exploratory study to identify the thinking styles inherent in ethical reflection by analyzing the reflection contents written by nursing students using text mining techniques. Participants: 73 among the students taking a nursing ethics course at a university in Seoul, South Korea, voluntarily participated in this study after providing informed consent. Methods: The public health ethics program was conducted with sessions held once a week for a total of 7 weeks, and reflections written by nursing students were collected as text files during session 5 to 7. In this study, data preprocessing process, keyword analysis, and LDA topic modeling were sequentially conducted utilizing the R program according to the data analysis procedure of text mining techniques. Ethical considerations: This study was conducted under ethics approval from the institution where participants were recruited. Findings and discussion: The results of this study show that the teaching method utilizing news articles enhanced rational ethical deliberation from the cognitive aspect, whereas the teaching method utilizing panel discussion material strengthened the response to emotions on a more internal level. Conclusions: The teaching method utilizing news articles and panel discussion materials in public health ethics education is expected to be mutually complementary and effective, so further studies are recommended.

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Dr. Himmatrao Bawaskar, a distinguished figure in Indian healthcare, has made significant contributions to medical research and public health, particularly in rural areas. Born in 1951 in Maharashtra, his journey from a rural upbringing to receiving one of the highest civilian awards of the Government of India, the Padma Shri, reflects his dedication to the field of medicine and public health. Dr. Bawaskar's groundbreaking research on scorpion stings, notably the use of prazosin, has revolutionized treatment protocols, significantly reducing mortality rates. Beyond scorpion stings, his work spans diverse medical areas, including snake bites and cardiovascular diseases. Moreover, Dr. Bawaskar's advocacy for ethical practices and healthcare reform underscores his commitment to improving healthcare outcomes. His legacy serves as an inspiration for future generations of healthcare professionals and policymakers, emphasizing the transformative power of dedication, compassion, and scientific inquiry in addressing critical healthcare challenges.

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BACKGROUND: Improving the ethical competencies of nursing students, as an important dimension of professional competence, is a primary objective of nursing education. Thus, this study aimed to explore a guide for codes of ethics for the development of ethical competence among nursing students in the healthcare system of Iran. METHODS: This is a systematic review and meta-synthesis of qualitative studies conducted in the healthcare system of Iran. The review included studies published between January 1, 2000 and March 2024. We conducted a comprehensive search in various international and national databases, including Web of Science, PubMed, Embase, PsycINFO, Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and SID. Initially, 86 qualitative studies were identified, and after a meticulous screening process, 39 studies were carefully reviewed. Finally, 10 qualitative studies were selected for analysis. The meta-synthesis employed an interpretive approach by thematic synthesis. RESULTS: Based on our results, four main themes and 10 categories, along with summarized codes, were extracted as crucial elements of the codes of ethics for the professional competence of Iranian nursing students. The main themes identified were knowledge, standards, experiences, and attitudes (KSEA). CONCLUSIONS: The concept of codes of ethics for developing professional competencies in Iranian nursing students was detected as a multidimensional concept with four major areas. By emphasizing the rights of clients and the standardization of nursing practice, this set of ethical codes can contribute to preventing clinical errors and legal issues at hospitals and educational settings. Furthermore, it fosters a positive environment that encourages professional behaviors among nursing students. Nursing students, as future nurses, should apply codes of ethics when facing emerging ethical challenges. Nurse educators have a crucial role in providing students with the necessary preparation and guidance during their professional socialization process in nursing schools.

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After almost a year and a half of the COVID-19 pandemic, many healthcare institutions in the United States announced that they would mandate COVID-19 vaccination, with medical and religious exceptions, as a term of employment. The mandates resulted in widely publicized protests from hospital staff, including some nurses, who argued that these medical institutions violated the ethical principle of autonomy. As the world enters the "post-pandemic period," decisions such as these, made during times of crisis, must be reviewed to provide clarity for when the next pandemic occurs. In this paper, we support the argument that such mandates are ethically justifiable. We explore the framework of objections that were brought forward by dissenters of this vaccine mandate. Next, we provide an analysis of conflicting ethical principles present when such mandates were deployed. Utilizing the American Nurses Association's Code of Ethics for Nurses, notably provisions 2, 3, and 6 we argue that it is an ethical duty of the nurse to be vaccinated. Specifically, we turn to provision two, which most explicitly underscores the necessity of vaccination as a function of the nurse's primary commitment to the patient. Next, we highlight the International Council of Nurses Code of Ethics which provides similar guidance internationally. Finally, we examine the applicability of the principles of public health, care ethics, and the nursing role as frameworks to underpin such mandates both for the current and for potential future pandemics, arguing that the nurse's ethical duty to be vaccinated spans these contexts.

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THE ETHICS OF IA IN MEDICINE MUST BE BASED ON THE PRACTICAL ETHICS OF THE HEALTHCARE RELATIONSHIP. Artificial intelligence (AI) offers more and more applications on the Internet, smartphones, computers, telemedicine. AI is growing rapidly in health. Transdisciplinary, AI must respect software engineering (reliability, robustness, security), knowledge obsolescence, law, ethics because a wide variety of algorithms, more or less opaque, process personal data help clinical decision. Hospital or city doctors and caregivers question the benefits/risks/costs of AI for the patient, the care relationship, deontology and medical ethics. Drawing on 30 years of experience in AI and medical ethics, the author proposes a first indicator of the ethical risks of AI (axis 1) evaluated by the surface of a radar diagram defined on the other 6 axes: Semantics, Opacity and acceptability, Complexity and autonomy, Target population, Actors (roles and motivations). Highly autonomous strong AI carries the most ethic risks.

L'ÉTHIQUE DE L'IA EN MÉDECINE DOIT REPOSER SUR L'ÉTHIQUE PRATIQUE DE LA RELATION DE SOIN. L'intelligence artificielle (IA) offre de plus en plus d'applications de santé sur smartphones, ordinateurs, télémédecine, internet des objets. Transdisciplinaire, l'IA doit respecter l'ingénierie logicielle (fiabilité, robustesse, sécurité), l'obsolescence des connaissances, le droit, l'éthique, car une grande variété d'algorithmes, plus ou moins opaques, traitent des données personnelles dans l'aide à la décision clinique. Médecins et soignants hospitaliers ou libéraux s'interrogent sur les bénéfices, risques, coûts de l'IA pour le patient, la relation de soin, la déontologie et l'éthique médicale. S'appuyant sur trente ans d'expérience en IA et en éthique médicale, cet article propose un premier indicateur des risques éthiques de l'IA (premier axe) défini par la surface du diagramme radar des autres axes (sémantique ; opacité et acceptabilité ; complexité et autonomie ; population cible ; acteurs [rôles et motivations]). L'IA forte autonome est celle qui comporte le plus de risques éthiques.

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Background and Aim: It is essential that healthcare providers display ethical behavior toward their patients. Despite development of codes of ethics for clinical practice, the occurrence of unethical behaviors toward patients is alarmingly high. The present study was conducted to identify the barriers to ethical treatment of patients in clinical environments. Methods: Through systematic narrative review, the present study investigated the barriers to ethical treatment of patients. This study was carried out in line with Assessment of Multiple Systematic Reviews 2 and Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines. Results: Ethical challenges in clinical environments can be classified into two categories: "organizational factors" and "personal factors." Organizational factors consist of three domains: managers and regulations, organizational environment, and human resources. Personal factors consist of two domains: factors related to patients and their families and factors related to care providers. Conclusion: Research shows that encouraging healthcare teams to adopt ethical behaviors through education and having them persistently observe ethics in their clinical practice will not completely bridge the gap between theory and practice: it seems that the clinical environment, the personal characteristics of healthcare team members and patients, and the organizational values of the healthcare system pose the greatest barrier to bridging this gap. Accordingly, in addition to raising healthcare providers' awareness of the existing issues in clinical ethics, measures should be taken to improve organizational culture and atmosphere.

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INTRODUCTION: The clinical practices of nurses should be in accordance with the principles of professional ethics. Respecting professional ethics principles depends on several factors. The present study was conducted to investigate the effective inhibitors and facilitators in compliance with professional ethics and their importance from the nurses' perspective. METHODS: During this cross-sectional descriptive study, 452 nurses were included by the census sampling method. The data were collected via the "inhibitors of compliance with professional ethics standards by the nurses' perspective" and "facilitators of compliance with professional ethics standards by the nurses' perspective" questionnaires. Additionally, by designing the "open-ended question" section, other inhibiting and facilitating factors of professional ethics standards from the nurses' perspective were investigated. The data were analyzed using descriptive and inferential statistics (Wilcoxon signed ranks test). RESULTS: The individual care-related dimension as a facilitator had the highest mean score compared to the other dimensions (76.62 ± 4.92). Furthermore, seven items in the inhibitor section, 19 items in the facilitator section had higher scores. Among them, there were seven items in common. Strong or weak belief in compliance with ethical issues had the highest mean scores in the role of facilitator and inhibitor (90.54 ± 12.13 and 89.54 ± 14.88, respectively). CONCLUSION: Strong or weak belief in compliance with ethical issues was the most important inhibitor and facilitator from the nurses' perspective, which makes it necessary to examine individual beliefs about ethical issues among applicants to enter the nursing profession.

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Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses' codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of ethics for nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses' Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses' codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses' ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed.

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Formulating codes of ethics for nurses are not only the need of establishing nurses’ professional image and dignity, but also the demand of nursing discipline development. By combing the relevant documents of codes of ethics for nurses at home and abroad, this paper summarized the main contents and application of codes of ethics for nurses, found that codes of ethics for nurses were based on the basic principle of "patient-oriented", discussing the relationship between nurses and patients, collaborators, environment, society, specialty and personal development, and forming the constraint standard for nurses’ behavior in combination with the expectation of local cultural values for nursing industry. The codes of ethics for nurses in China need to further clarify the scope of nursing, formulate behavioral norms in various specialties, and through clinical evaluation, education, management and other aspects to promote its popularization and implementation.

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Background: Artificial intelligence (AI) is predicted to be a solution for improving healthcare, increasing efficiency, and saving time and recourses. A lack of ethical principles for the use of AI in practice has been highlighted by several stakeholders due to the recent attention given to it. Research has shown an urgent need for more knowledge regarding the ethical implications of AI applications in healthcare. However, fundamental ethical principles may not be sufficient to describe ethical concerns associated with implementing AI applications. Objective: The aim of this study is twofold, (1) to use the implementation of AI applications to predict patient mortality in emergency departments as a setting to explore healthcare professionals' perspectives on ethical issues in relation to ethical principles and (2) to develop a model to guide ethical considerations in AI implementation in healthcare based on ethical theory. Methods: Semi-structured interviews were conducted with 18 participants. The abductive approach used to analyze the empirical data consisted of four steps alternating between inductive and deductive analyses. Results: Our findings provide an ethical model demonstrating the need to address six ethical principles (autonomy, beneficence, non-maleficence, justice, explicability, and professional governance) in relation to ethical theories defined as virtue, deontology, and consequentialism when AI applications are to be implemented in clinical practice. Conclusions: Ethical aspects of AI applications are broader than the prima facie principles of medical ethics and the principle of explicability. Ethical aspects thus need to be viewed from a broader perspective to cover different situations that healthcare professionals, in general, and physicians, in particular, may face when using AI applications in clinical practice.

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BACKGROUND: Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. RESEARCH QUESTION/AIM/OBJECTIVES: The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet direct patient care settings? RESEARCH DESIGN: This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. PARTICIPANTS AND RESEARCH CONTEXT: Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. ETHICAL CONSIDERATIONS: Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. FINDINGS: 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement (p = 0.38), professional values (p = 0.037), practice environment: participation in hospital affairs (p = 0.00), foundations for quality care (p = 0.016), and resources adequacy (p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably (p = 0.00), got help as soon as wanted (p = 0.00), and treated with courtesy and respect (p = 0.00). DISCUSSION/CONCLUSIONS: Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MESH TERMS: Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction.

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INTRODUCTION: Two ethical challenges of nursing home nurses during the COVID-19 pandemic in Sweden are discussed in this paper. BACKGROUND: Historically, the nurse's primary concern is for the person who is ill, which is the core of nurses' moral responsibility and identity. In Sweden, person-centered care is generally deemed important in nursing older nursing home residents. OBJECTIVE: To chart moral responsibilities of nursing home nurses in two cases involving older residents during the COVID-19 pandemic in Sweden. METHODS: We used Margaret Urban Walker's framework for moral responsibilities and the International Council of Nurses (ICN) code of ethics for nurses (2021) for our normative analysis. ETHICAL CONSIDERATIONS: Written and verbal consent was obtained before the interviews, and information was given that participation was entirely voluntary and possible to cancel at any time before the work was published. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to this research project (Dnr. 2020-05649). FINDINGS: Case #1: a palliative older nursing home resident who was coercively tested for COVID-19, and case #2: a COVID-19-infected resident with dementia who was isolated using sedation. The decision that was finally made in the respective case was analyzed in the light of either consequentialist/utilitarian or non-consequentialist/deontological reasons. DISCUSSION: Empowerment of nurses as moral agents is required for the application of practical wisdom in the balancing of different care relationships (responsibilities), moral identities (professional virtues), and competing moral values. This requires resources and opens possibilities for profound ethical reflection in nursing education and at work. CONCLUSION: During the COVID-19 pandemic, the moral and professional responsibility of nursing home nurses to deliver person-centered care was sometimes problematically abandoned in favor of a more utilitarian manner of ethical decision-making.

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BACKGROUND: Ethical decision-making education in nursing can be taught effectively by combining different teaching models that support the visualisation of taught concepts and integrating theory into practice. OBJECTIVES: The study aims to examine the effect of flipped and jigsaw learning models on ethical decision-making and ethical sensitivity in nursing. RESEARCH DESIGN: We used a nested mixed design. A pretest-posttest single-group quasi-experimental design was used in the quantitative part, and a case study method was used in the qualitative part. PARTICIPANTS AND RESEARCH CONTEXT: This study was conducted in fall semester with second-year nursing students who studied an ethics course for the first time, using two different collaborative learning models. In the quantitative part, ethical dilemma and ethical sensitivity scales were made as pre-test with 117 and post-test with 128 students. In the qualitative part, a semi-structured three focus group interviews was conducted with 16 students. ETHICAL CONSIDERATIONS: After obtaining the approval of the University's ethics committee, the study was carried out after obtaining participants' informed written and verbal consent. FINDINGS: Students' perspectives changed positively after training. This was related to six cases in section A of the Ethical Dilemma Scale. In part B, Practical Consideration (PC) and Principled Thinking (PT) mean scores were similar, showing no significant difference. For Familiarity in section C, it was determined that 68.4% of students in the pre-test and 77.3% in the post-test were familiar with similar dilemmas. The ethical sensitivity scale's total scores were in a similar range. In the qualitative stage, ethical decision-making, ethical sensitivity, ethical dilemma and the improvement process were obtained as a theme. CONCLUSIONS: There was an increase in the level of ethical sensitivity and familiarity with ethical dilemmas of nursing students after education. Flipped and jigsaw learning models can be used for nursing ethics courses.

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EVOLUTIONS OF THE "FRAMEWORK OF BENEFITS" SYSTEM. In the field of compliance, the last thirty years have been marked by an evolution of the regulatory framework in order to adapt an anti-corruption system to the whole ecosystem of health professionals and industrialists. Although the various developments now make the "framework of benefits" a solid legislative construction, the latest news shows the need to move towards a reinforcement of illegal practices as well as a framework of canvassing for promotion between industrialists and health professionals. However, the construction of this legal framework has given rise to concerns and questions, particularly from physicians' associations, concerning their training prospects and their search for funding.

ÉVOLUTIONS DU DISPOSITIF « ENCADREMENT DES AVANTAGES ¼. Dans le champ de la compliance (ou conformité), les trente dernières années ont été marquées par une évolution du cadre réglementaire afin d'adapter un dispositif anticorruption à l'ensemble d'un écosystème de professionnels de santé et d'industriels. Si les différentes évolutions font désormais du dispositif « Encadrement des avantages ¼ une construction législative solide, les dernières actualités montrent la nécessité de tendre vers un renforcement de l'encadrement des pratiques illégales ainsi qu'un encadrement du démarchage à la promotion entre les industriels et les professionnels de santé. La construction de ce cadre juridique a toutefois été à l'origine d'inquiétudes et de questionnements, notamment des associations de médecins concernant leurs perspectives de formation et leur recherche de financements.

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Sometimes, when a public health disaster strikes, mandatory freedom-limiting restrictions must be enforced in order to save lives. During the first waves of the COVID-19 pandemic, the customary and necessary exchange of ideas in academia drastically changed in most countries, and the absence of debate on the restrictions enforced became evident. Now that the pandemic seems to be drawing to an end, the aim of this article is to spark clinical and public debate on the ethical issues concerning pediatric COVID-19 mandates in an attempt to analyze what happened. With theoretical reflection, and not empirical inquiry, we address the mitigation measures which proved detrimental to children despite being beneficial to other segments of the population. We focus on three key points: (i) the sacrifice of fundamental children's rights for the greater good, (ii) the feasibility of cost-benefit analyses to make public health decisions and restrictions which affect children, and (iii) to analyze the impediments to allowing children's voices to be heard concerning their medical treatment.

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Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and 'multivocal', that is, they usually underdetermine or provide more than one answer to the question, 'What should I do now?' Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation-collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine.

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Awareness of ethics codes and professional guidelines is crucial to a professional role in psychotherapy practice. Psychotherapy practice is increasingly heterogeneous, and there is much discussion about their effectiveness for clients. In some countries, psychotherapy is an autonomous profession. In others, is part of the professional features of psychologists and psychiatrists, and it is possible to find other health professionals working as psychotherapists in some countries. Considering that ethical principles are central to the performance of a profession, we intend to find connections between the ethical principles for psychotherapists and psychologists or psychiatrists. A critical review was done to promote an integrative vision of ethics codes in psychotherapy. Content analysis of the ethics codes in psychotherapy was per-formed. Confidentiality, competence, and integrity were the principles more frequently found. Psychotherapists seem to have a major concern with interpersonal relationshipsand are less linked to social responsibility. (AU)

El conocimiento de los códigos éticos y las directrices profesionales es crucial para desempeñar un papel profesional en la práctica de la psicoterapia. La práctica de la psicoterapia es cada vez más heterogénea y se discute mucho sobre su eficacia para los clientes. En algunos países, la psicoterapia es una profesión autónoma. En otros forma parte de las características profesionales de psicólogos y psiquiatras, y es posible encontrar a otros profesionales de la salud trabajando como psicoterapeutas en algunos países. Considerando que los principios éticos son centrales para el desempeño de una profesión, pretendemos encontrar conexiones entre los principios éticos para psicoterapeutas y psicólogos o psiquiatras. Se realizó una revisión crítica para promover una visión integradora de los códigos de ética en psicoterapia. Se realizó un análisis de contenido de los códigos de ética en psicoterapia. La confidencialidad, la competencia y la integridad fueron los principios más frecuentemente encontrados. Los psicoterapeutas parecen tener una mayor preocupación por las relaciones interpersonales y están me-nos vinculados a la responsabilidad social. (AU)

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BACKGROUND: Paramedicine is a newly regulated profession in Australia and with the introduction of regulation in 2018 for this profession came increased responsibilities - including the introduction of a professional code of conduct. Several countries now have regulation of paramedicine and associated professional codes to guide ethical and professional behaviour. Despite this, there has been no published research into paramedic understanding and use of their professional codes. OBJECTIVES: To explore Australian paramedics' use and understanding of their professional code of conduct. Research design: This study used a qualitative descriptive design, underpinned by hermeneutic theory. Reflexive thematic analysis was used to analyse the interview data and identify Australian paramedic perceptions surrounding the use of their code of conduct. RESULTS: 11 Registered Paramedics from several states and territories were interviewed. Participants were invited to interview by advertisement on social media and the Australasian College of Paramedicine Web site. Participants had varied professional backgrounds including clinical work, education providers and policymakers/managers. Four themes were identified as follows: Theme 1 - 'You don't know, what you can't know'; Theme 2 - 'I don't need the code - the code is for others'; Theme 3 - 'It's about time'; Theme 4 - 'Navigating the new profession'. Ethical considerations: Ethics approval was granted by the Monash University Human Research Ethics Committee (MUHREC) Project ID: 28921. All participants provided informed consent. CONCLUSIONS: The results of this study suggest that paramedics' knowledge and use of their code is limited, and participants appeared to mostly rely instead on 'common sense' morals. Participants did appear to want to understand the broad concepts of the code more and have this better integrated into the profession. The code was also interpreted as important to the paramedic profession and its new professional status, helping to legitimise it as a health profession in Australia.

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To deliver effective medical services and establish trust and psychological security in patients, care providers must prioritize ethical principles. Developing a comprehensive clinical education program for learners, along with specific ethical guidelines, and implementing managerial and executive interventions necessitates a thorough understanding of the ethical challenges within this field. This qualitative study aimed to elucidate the ethical issues faced by otolaryngologists. Sixteen otolaryngologists participated in the study, selected through purposive sampling. Data were gathered through semi-structured interviews, and the analysis, conducted through conventional content analysis, revealed eight main categories and 38 subcategories encapsulating the identified ethical issues. The primary categories encompassed ethical issues faced by otolaryngologists concerning patients and companions, education, communication with the treatment team, physicians' rights, medical tourism, medical advertising, cultural considerations, and managerial challenges. resources and treatment approaches in alignment with Iranian cultural norms, address conflicts between treatment and education, and implement sound management plans to uphold rights of the treatment team. Additionally, the study suggests the necessity of ethical advertising programs and the strategic promotion of therapeutic tourism.