Economic pressures strain physicians’ ethical practice in hospitals, qualitative study finds

A qualitative study published in BMC Medical Ethics examines how physicians experience the tension between their ethical obligations and the financial constraints of modern hospital systems. Using an interpretive phenomenological approach, researchers interviewed 12 physicians, including general practitioners and specialists, who work in both public and private hospitals. The study, published on 24 October 2026, explores how economic pressures shape clinical decision-making, professional identity and psychological well-being.

The researchers conducted semi-structured, in-depth interviews that were audio-recorded with informed consent and transcribed verbatim. Data were analysed using van Manen’s phenomenological thematic analysis, in which meaningful units, subthemes and overarching themes were identified. Trustworthiness was addressed through credibility, dependability and confirmability criteria.

The analysis revealed four main themes: conflict between ethical obligations and economic constraints; psychological and emotional burden; coping and adaptation strategies; and impact on professional identity and the physician–patient relationship. Physicians reported dual-role dilemmas, moral distress, and difficulty balancing patient care with institutional financial pressures. According to the authors, these tensions influenced physicians’ ethical decision-making, emotional health and perceptions of their professional identity.

The coping strategies participants described included moral justification, clinical creativity, silent resistance and acceptance of economic realities. The authors conclude that economic pressures in hospital settings significantly affect physicians’ ability to practise ethically and maintain professional ideals, and they argue that addressing this conflict requires institutional and policy-level interventions that reduce financial pressures, support ethical decision-making and promote a balance between economic efficiency and professional medical values.

As a qualitative study with 12 participants, the findings describe the lived experiences of this specific group of physicians rather than measuring how widespread these conflicts are across the wider medical workforce. The authors note that the results highlight the importance of structural support for ethical medical practice and have broader implications for healthcare quality, patient trust and physician well-being. The article is open access and was released as a version subject to further edits, to be replaced by the final Version of Record.

Subject of Research: Physicians' lived experiences of conflicts between medical ethics and economic pressures in hospital settings

Article Title: Medical ethics under economic pressure: physicians’ lived experiences in hospital settings

Article References: Kazemi, M., & Moradi, A. (2026). Medical ethics under economic pressure: physicians’ lived experiences in hospital settings. BMC Medical Ethics. https://doi.org/10.1186/s12910-026-01647-5

Image Credits: AI Generated

DOI: 10.1186/s12910-026-01647-5

Keywords: medical ethics, economic pressure, qualitative research, physicians, moral distress, hospital settings, professional identity, physician-patient relationship, phenomenology, healthcare policy, Medical, ethics