Original Article

Defensive medicine in surgical disciplines: attitudes and practices among faculty and residents at Iran University of Medical Sciences

Abstract

Defensive medicine, driven by fear of litigation, increases healthcare costs and physician stress, particularly in high-risk specialties such as surgery. This study investigates the attitudes and practices of faculty members and residents in surgical discipline regarding defensive medicine. In this cross-sectional study, 147 surgeons (faculty, residents, and fellows) from IUMS teaching hospitals completed a validated questionnaire assessing attitudes toward the ethicality of defensive medicine and the prevalence of defensive practices. Data were analyzed using SPSS version 24, applying chi-square tests, independent t-tests, and Mann-Whitney U tests.Nearly half of the participants (48.9%) considered defensive practices ethical. Common defensive behaviors included consultation referrals (47.6%), unnecessary laboratory tests (36.7%), and avoidance of high-risk procedures (44.3%). Key concerns driving defensive practices were non-expert judicial rulings (35.4%), stress related to high-risk patients (34.7%), and litigation costs (35.2%). Factors such as intervention type (32%) and lack of awareness of ethical standards (27.2%) were associated with increased defensive behaviors. General surgery (29.8%) and orthopedics (17%) reported the highest conviction rates. The results showed that defensive medicine is prevalent among surgeons at IUMS due to legal fears and low self-confidence.Enhancing targeted education and establishing clear ethical guidelines may reduce defensive practices and improve surgical care delivery.

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IssueVol 18 (2025) QRcode
SectionOriginal Article(s)
Keywords
Defensive medicine; Surgical residents; Attitudes; Medical ethics; Surgeons.
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How to Cite
1.
Fahimi M, Sayad S, Noroozi M, Shamsi Gooshki E, Zarghami SY, Shahrezaei A, Forouzandeh M. Defensive medicine in surgical disciplines: attitudes and practices among faculty and residents at Iran University of Medical Sciences. J Med Ethics Hist Med. 2025;18.