Ethical challenges of health care system personnel in natural disasters: A qualitative study

The professional competence of health personnel depends on adherence to the principles of professional ethics, and given the importance that the issue of professional ethics in natural disasters becomes more important, Therefore this study was conducted to investigate the ethical challenges of health care system personnel in natural disasters.                                                     

This qualitative study was conducted with a conventional content analysis approach. Participants were 38 employees of Lorestan University of Medical Sciences who were present at the Lorestan 1398 flood incident for at least two days to provide relief and willingness to participate in the study. Data were analyzed using in-depth semi-structured face-to-face interviews with the aim of understanding non-verbal evidence. The interview guide was used to focus on the content of the interview.

In this study, 38 medical staff of Lorestan province participated in the study. 66% of the participants were women and 44% were men. 37% were married and 63% were single, with a mean age of 42 years. The data were analyzed with 58 initial codes in 15categories and five main themes. The results of data analysis were divided into the following five concepts: Injustice extracted from classes such as inadequate distribution of resources and locations, crisis management deficits resulting from classes such as lack of coordination in service delivery, lack of pre-accident planning, and so on. Delays in the provision of services resulting from classes such as delays in receiving medication and medical services. Responsibility and conscience:  These two concepts were extracted simultaneously with classes such as empathy, compassion and kindness, self-sacrifice, hospitality, humanity, and difficulty in enduring heartbreaking scenes.                                                                                                                          

The crystallization of manifestations of national determination and jihadi will, donations, public presence, empathy and kindness, the beauty of religion and culture in times of national crises are among the strengths obtained in this study. Despite the positives, there were challenges such as inconsistencies between aid centers, lack of adequate planning and training of staff, inequality in the distribution of services and facilities, delays in service delivery, and injustice. It seems that the root of these problems is the lack of scientific planning before, during and after the crisis, the lack of coordination of the responsible bodies during the crisis and the basic problems in the infrastructure. It is suggested that in order to reduce the problems, more studies be done in the field of rooting out the problems and how to eliminate the mentioned shortcomings.