The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and
treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical
decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal
intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of
Iran.
In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians' and
nurses' perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and
nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations.
The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency
calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by
Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22.
Respecting patients' rights and interactions with parents were perceived as the most challenging aspects of
neonatal care. There were significant differences between sexes in the domains of the perceived challenges.
According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job.
The results of our study showed that the most challenging issues were related to patients' rights, interactions with
parents, communication and cooperation, and end of life considerations respectively. It can be concluded,
therefore, that more attention should be paid to these issues in educational programs and ethics committees of
hospitals.
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