Family medicine ethical issues regarding physician-patient interactions from patients' perspectives: A qualitative study

Background: The physician-patient relationship is important because the patient's satisfaction affects trust in physician and accepting physician's recommendations in medical treatment decisions. Understanding a patient's opinion about a trustworthy and friendly physician as well as ethical issues regarding family medicine, therefore, gains double importance. This paper attempts to provide a comprehensive evaluation of the subject. Methods: In summer 2018, a conventional qualitative content analysis was done on 21 participants who were referred to family physicians in the North of Iran. Data were collected by means of purposive sampling and semi-structured face to face individual interviews. Participants shared their experiences about ethical considerations in family medicine. All interviews were recorded and transcribed word for word, data were analyzed using qualitative content analysis. Results: Data analysis resulted in the extraction of 7 categories and 21 sub-categories from the 71 initial codes. The categories include "responsibility", "patient's privacy", "informed consent", "respect and dignity of patient", "effective physician-patient communication", "trust in physician" and "conflict of interests". Conclusion: There are some differences between the participants' perceptions of ethical considerations in family medicine and opinions of medical ethics curriculum designers in Iran and particularly in the world. Some shared elements including "resource allocation", "the beginning and end of life", "research ethics", "substitute decision-making", etc. - all of them are main titles of ethics curriculum - could not be weighed as major ethical issues from the patients' perspectives. The patient's satisfaction and, therefore, the enhancement of mutual trust is essential. Patients' comments should be considered when providing ethical guidelines.