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Healthcare
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Ethical Challenges in Healthcare Professions: Decision-Making in Uncertain Scenarios
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Ethical Challenges in Healthcare Professions: Decision-Making in Uncertain Scenarios

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 1 August 2026 | Viewed by 1262

Special Issue Editors

Prof. Dr. Beatriz Rodriguez-Martin

E-Mail Website
Guest Editor
Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
Interests: aging; nursing
Dr. Pablo A. Cantero Garlito

E-Mail Website
Guest Editor Assistant
Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, Universidad de Castilla La Mancha, 45600 Talavera de la Reina, Spain
Interests: occupational therapy; sexology; LGBT studies; care; sexuality
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

We are pleased to invite you to contribute to the Special Issue “Ethical Challenges in Healthcare Professions: Decision-Making in Uncertain Scenarios” in Healthcare. Ethical decision-making is a cornerstone of clinical practice, yet healthcare professionals are increasingly confronted with complex, ambiguous situations where clear-cut answers are absent. From rapidly evolving medical technologies to emergencies such as pandemics and end-of-life care dilemmas, these scenarios demand not only scientific competence but also ethical clarity and integrity. 

This Special Issue aims to explore the ethical dimensions of decision-making within healthcare, especially under conditions of uncertainty. It aligns with Healthcare’s scope by addressing interdisciplinary and practical challenges in delivering responsible, equitable, and person-centered care. Contributions may examine how healthcare workers navigate moral conflict, institutional constraints, cultural expectations, and patient autonomy when clear evidence or consensus is lacking. 

In this Special Issue, original research articles, case studies, and comprehensive reviews are welcome. Research areas may include (but are not limited to) the following: clinical ethics, bioethics education, moral distress, AI and digital ethics in care, triage protocols, and decision-making frameworks in uncertain or crisis contexts. 

We look forward to hearing from you.

Prof. Dr. Beatriz Rodriguez-Martin
Guest Editor

Dr. Pablo A. Cantero Garlito
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ethical decision-making
  • clinical ethics
  • uncertainty in healthcare
  • moral distress
  • bioethics
  • healthcare professionalism
  • crisis and emergency ethics
  • patient autonomy
  • interdisciplinary ethics
  • ethical frameworks in clinical practice

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

15 pages, 262 KB  
Article
Clinical Empathy, Personality Traits, and Resilience in Advanced Nursing Students: A Cross-Sectional Secondary Analysis
by Sonia Prieto de Benito, Ivan Herrera-Peco, Lina M. García-Nieto, Carlos Ruíz-Núñez, Andrés García-Notario, Silvia María Campos-Soler, Gema Mata-González and Fidel López-Espuela
Healthcare 2026, 14(11), 1454; https://doi.org/10.3390/healthcare14111454 - 25 May 2026
Abstract
Background/Objectives: Clinical empathy is a core competency in nursing education and is conceptually relevant to person-centered nursing care. However, limited evidence is available on how clinical empathy in advanced nursing students is associated with dispositional characteristics such as personality traits and resilience. This [...] Read more.
Background/Objectives: Clinical empathy is a core competency in nursing education and is conceptually relevant to person-centered nursing care. However, limited evidence is available on how clinical empathy in advanced nursing students is associated with dispositional characteristics such as personality traits and resilience. This study aimed to examine cross-sectional associations between clinical empathy, Big Five personality traits, and resilience in third- and fourth-year nursing students. Methods: A descriptive, cross-sectional secondary analysis was conducted using an existing survey database. The final analytic sample comprised 66 third- and fourth-year nursing students from a nursing school in Spain. Clinical empathy was assessed with the Jefferson Scale of Empathy, resilience with the 6-item Brief Resilience Scale, and personality traits with the Big Five Inventory-44. Life satisfaction, academic engagement, and general self-efficacy were included as secondary psychosocial variables. Descriptive analyses, correlation analyses, group comparisons, and exploratory multiple linear regression were performed. Results: Higher agreeableness was associated with higher total clinical empathy (ρ = 0.390, p = 0.001) and perspective-taking (ρ = 0.440, p < 0.001). Higher conscientiousness was also associated with higher total clinical empathy (ρ = 0.480, p < 0.001), perspective-taking (ρ = 0.432, p < 0.001), and compassionate care (ρ = 0.324, p = 0.008). In the exploratory multivariable cross-sectional model, agreeableness and conscientiousness were independently associated with total clinical empathy, whereas resilience was not. Findings involving the Standing in the Patient’s Shoes subscale should be interpreted cautiously because of its low internal consistency. Conclusions: In this exploratory sample of advanced nursing students, self-reported clinical empathy was associated mainly with agreeableness and conscientiousness. These findings should be interpreted as cross-sectional associations based on self-report data and should not be taken as evidence of causal effects, ethical behavior, or person-centered care practices. Further longitudinal and multicenter studies are needed to examine whether these associations are stable and whether they relate to observable educational or clinical outcomes. Full article
(This article belongs to the Special Issue Ethical Challenges in Healthcare Professions: Decision-Making in Uncertain Scenarios)
12 pages, 260 KB  
Article
Ethical Conflicts and Knowledge of the Code of Ethics Among Occupational Therapists in Spain
by Daniel Emeric-Méaulle, Pablo A. Cantero-Garlito and Ana A. Laborda-Soriano
Healthcare 2026, 14(3), 367; https://doi.org/10.3390/healthcare14030367 - 31 Jan 2026
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Abstract
Objective: This study characterized Spanish occupational therapists’ knowledge of the national Code of Ethics and perceptions of professional ethics and examined associations with sociodemographic and educational variables. It quantified knowledge of key Code elements (approving body and professional values), described ethics education and [...] Read more.
Objective: This study characterized Spanish occupational therapists’ knowledge of the national Code of Ethics and perceptions of professional ethics and examined associations with sociodemographic and educational variables. It quantified knowledge of key Code elements (approving body and professional values), described ethics education and participation in formal ethical support structures, and identified resources used to manage ethical conflicts in routine practice. Methods: A descriptive cross-sectional online survey was administered between March and September 2022. The analytical sample included 596 occupational therapists practicing in Spain. The questionnaire assessed participant characteristics, ethics education, knowledge and perceived importance of the Code, participation in ethics committees or similar structures, experience of ethical conflicts, and conflict-management strategies. Descriptive and bivariate analyses were conducted (p < 0.05). Results: Respondents were mostly women (86.6%) and aged 20–40 years. Although 65.3% reported university ethics education and 73.2% rated the Code as important/very important, 11.4% were unaware of its existence. Only 28.2% identified the approving body, and 16.3% correctly identified the professional values included in the Code. Ethical conflicts were reported by 43.1%. When conflicts occurred, respondents most often consulted the interdisciplinary team (25.5%) or occupational therapy colleagues (24.3%), whereas few consulted the Code (4.5%) or an ethics committee (2.7%). Ethics education and greater professional experience were associated with higher Code knowledge. Conclusions: Occupational therapists in Spain endorse professional ethics, yet actionable knowledge and use of the Code and engagement with formal support structures remain limited. Strengthening practice-oriented ethics education and accessible deliberation mechanisms may improve ethical decision-making. Full article
(This article belongs to the Special Issue Ethical Challenges in Healthcare Professions: Decision-Making in Uncertain Scenarios)
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