Medical ethics is defined as the ethical obligations of healthcare professionals toward their patients, colleagues, and society [1]. Public concern regarding the ethical conduct of healthcare professionals has been steadily increasing, often resulting in complaints about unethical behavior. Consequently, the Hippocratic Oath, professional codes of conduct, and the laws governing medical practice are regularly developed and updated to promote ethical standards [2]. Codes of medical ethics require physicians to provide assistance in situations of serious danger and medical emergencies. No code of ethics opposes this obligation, which has always been regarded by the medical profession as a fundamental duty [3]. The provisions of the International Code of Medical Ethics concerning emergency care state that physicians must provide the necessary care in emergencies as a humanitarian obligation. They may withdraw only after ensuring that another qualified person will continue the patient’s care [3]. In emergency situations, the factor of time plays a crucial role and may directly influence the physician’s decisions and conduct [3]. Several studies have documented the development of medical practice and the acquisition of professional competencies through socialization processes occurring in different work environments. Practical norms and professional attitudes are progressively developed, complementing the academic training of healthcare professionals [4]. In Western countries, contemporary healthcare increasingly emphasizes the individual as a person. Plourde S., in TheConceptofPerson: AKeytotheEthicalDimensionofTechnoscientificPossibilities, argues that personhood encompasses not only the highest neuropsychological stage of human ontogenesis but also the integration of all aspects of human nature, the uniqueness of the self, and the process of becoming oneself through relationships with others. In this perspective, personhood is not an inherent given but an ontological and primarily ethical achievement whose rights continue to generate debate and inspire ethical reflection and social action [5]. In France, according to the Circular of March 2, 2006 [6], “Informationprovidedtothepatientmustbeclear, accessible, andhonest. Thepatientparticipatesintherapeuticdecisionsconcerninghisorhercareandmaybeassistedbyatrustedpersonofhisorherownchoosing.” Furthermore, “Amedicalproceduremayonlybeperformedwiththepatient’sfreeandinformedconsent. Everypatienthastherighttorefusetreatment. Anycompetentadultmayexpresswishesregardingend-of-lifecarethroughadvancedirectives.” The circular also states that “Hospitalizedpatientsmustbetreatedwithrespect. Theirbeliefsmustberespected, andtheirprivacyandtranquilitypreserved.” In addition, “Hospitalizedpatients (ortheirlegalrepresentatives) havedirectaccesstotheirmedicalinformation. Undercertainconditions, nextofkinmayalsoaccesssuchinformationafterthepatient’sdeath.” [6] In Africa, certain ethical and professional issues related to medical care are addressed within a specific cultural context that is not always fully considered by universal ethical approaches [7]. In Guinea, however, published data on healthcare professionals’ knowledge and attitudes regarding medical ethics and professional conduct remain scarce. Therefore, this study was undertaken to assess the knowledge and practical attitudes of healthcare personnel regarding medical ethics and professional conduct at the Regional Hospital of Labé.

Healthcare professionals must constantly reconcile the ethical obligations imposed by their profession with their own moral judgment when facing complex clinical situations. Although ethics and professional conduct are complementary concepts, they both guide daily clinical practice. In the present study, the mean age of healthcare providers was 35.4 ± 9.7 years, and the 31 - 40-year age group was the most represented (38.78%). Adhikari etal. [8] reported a mean age of 28.66 years among physicians and 27.69 years among nurses, with males accounting for 67.8% of participants. A similar male predominance was observed in our study (55.10%). Regarding professional categories, nurses constituted the largest group (57.83%), followed by physicians (32.65%). This finding is comparable to that of Hariharan etal. [9], who reported that 47% of respondents were physicians and 53% were nurses, but differs from the findings of Adhikari etal. [8], who reported that physicians accounted for 67.8% and nurses 32.2% of participants. With respect to years of professional experience, most respondents (31.96%) had 6 - 12 years of experience (Figure 1). This result is consistent with that of Hariharan etal. [9], who found that 65% of junior physicians had 4 - 10 years of professional experience, while 60% of nurses had 7 - 20 years of experience. In our study, almost all respondents (95.2%) reported being familiar with the concept of medical ethics. The main source of information was medical schools and health training institutions (74.83%). Similarly, Mouté P.B. [10] reported that 80.3% of healthcare professionals had first heard about medical ethics at medical school or health training institutions, and among those familiar with medical professional conduct, 90.4% cited medical school as their primary source of information. Several studies have shown that physicians prefer learning ethics and law through lectures, books, and journals, whereas nurses tend to rely mainly on journals and ethics textbooks [11]. Likewise, previous studies have identified lectures and books as the predominant sources of ethics education among both physicians and nurses [11]-[13]. Our findings may be explained by the systematic integration of ethics and professional conduct into the curricula of medical schools and health training institutions in Guinea. Most respondents (43.54%) defined medical ethics as the set of rules and laws governing healthcare practice. This definition is incomplete and somewhat restrictive and may reflect the fact that ethics education was neglected for many years and has only recently been systematically incorporated into medical education in Guinea. Similar observations have been made in Nepal, where medical graduates receive barely 10 hours of formal teaching in healthcare ethics throughout their training. There, ethics education is mainly provided by forensic medicine departments and focuses primarily on medico-legal issues. Nurses likewise receive limited training in medical ethics [8]. Nevertheless, the fact that more than two-fifths of respondents demonstrated an understanding of the concept of medical ethics suggests that current training programs now provide essential knowledge on ethics to both medical and nursing students before graduation. Knowledge of the Code of Medical Ethics was confirmed among 76.19% of respondents. Among them, 45.58% reported obtaining it from the Medical Council, whereas 39.46% indicated the Ministry of Health and Public Hygiene. In the study by Mouté P.B., 90.4% of respondents who were aware of the Code of Medical Ethics cited medical school as their source [10]. Our findings may reflect the continuous efforts of the National and Regional Professional Councils in Guinea to disseminate and promote the Code of Medical Ethics through awareness campaigns aimed at improving the quality of patient care. More than four out of five respondents (87.07%) were aware of the existence of professional regulatory bodies. This high level of awareness may be explained by the fact that registration with a professional council is a mandatory requirement for practicing medicine in both the public and private sectors in Guinea. In addition, professional registration is frequently required when applying for postgraduate medical training abroad. Most respondents (89.12%) believed that the primary role of professional regulatory bodies is to ensure compliance with the Code of Medical Ethics. Similarly, 89.12% considered that healthcare professionals have a duty to ensure patient safety, while 78.23% recognized their natural protective role toward patients. According to Sermo (2025), healthcare providers and their employees are required to safeguard the confidentiality of all medical records and patient health information [14]. Almost all respondents (99.32%) recognized that patients have the right to receive quality healthcare, while 85.71% acknowledged patients’ right to access their medical records. These findings may reflect the education received during professional training and are consistent with the International Code of Medical Ethics (2022), which states that “Physiciansmustrespectthepatient’srighttobeinformedateverystageofthecareprocess” [15]. Knowledge of the patient’s right to compensation for proven medical negligence was observed in 81.63% of respondents, probably because this principle is now included in ethics and professional conduct training programs. According to psychoanalytic and social science theories, secrecy is maintained through a structure involving three actors: the holder of the information, the recipient, and the custodian. Family and social relationships are organized around this structure of inclusion and exclusion regarding confidential information [16]. Caizergues and Cianfarani [17] emphasized that the French Code of Medical Ethics specifies that medical confidentiality covers not only information entrusted to physicians but also everything they see or hear during the exercise of their profession. Furthermore, medical confidentiality also applies to the parents of competent adult patients. Similarly, Article 367 of the Guinean Penal Code provides that the disclosure of confidential information by a person entrusted with such information because of their profession or duties is punishable by 6 months to 1 year of imprisonment and/or a fine ranging from 500,000 to 2,000,000 Guinean francs [18]. More than half of the respondents (55.10%) considered informed consent to be both a physician’s duty and a patient’s right. This proportion is lower than that reported by Mouté P.B., who found that 83.5% of healthcare professionals stated that they explained procedures to patients and obtained oral informed consent before providing care [10]. Diarra M.G. etal. [19] reported a rate of 100% in their study. Another study found that 55% of healthcare professionals believed that medical procedures should only be performed after obtaining the patient’s free and informed consent, whereas 34.5% considered informed consent unnecessary because patients should place complete trust in their healthcare providers [10]. The concept of medical liability was familiar to 52.59% of respondents. Among them, 49.15% mentioned disciplinary liability, 34.05% criminal liability, and 16.80% civil or administrative liability or provided no answer. Only 6.30% admitted having committed a medical error during professional practice. These findings are comparable to those of Traoré D. etal. [20] in Burkina Faso, where 44% of practitioners cited disciplinary liability, 24% mentioned both criminal and disciplinary liability, and only 1.1% acknowledged having committed a medical error. Other African studies have similarly reported limited knowledge of the legal aspects of medical practice among healthcare professionals [20][21]. According to Thouvenin [22], medical liability is essentially fault-based liability. The concept of fault also highlights the tension between medicine and the legal system, raising the question of whether the courts judge the practitioner or the medical act itself. Healthcare professionals generally believe they should not be held liable because they always act to the best of their abilities. Likewise, Traoré D. etal. [20] reported that many practitioners in Burkina Faso were unfamiliar with punitive medical liability, and some believed that they bore no legal responsibility for their professional actions. Regarding professional attitudes toward patients, 93.20% considered informing patients about their illness to be both a legal and ethical obligation. Nearly half (47.62%) believed that when a patient refuses treatment, healthcare professionals should first verify that the patient has fully understood the information provided and repeat the explanation if necessary. Furthermore, 63.95% stated that they systematically considered patients’ complaints during care, while 62.59% reported routinely informing patients about the nature and modalities of treatment and obtaining informed consent before every medical procedure. However, 25.85% provided information without obtaining consent, whereas 10.20% obtained consent without providing adequate information. According to the International Code of Medical Ethics, physicians must obtain the patient’s voluntary and informed consent before any medical intervention after ensuring that the patient has received and understood all relevant information. Physicians must also respect a patient’s decision to refuse or withdraw consent at any time and for any reason [15]. In a survey conducted by Sermo, one physician in four identified informed consent as a major ethical concern, emphasizing that it is a cornerstone of ethical healthcare because it enables patients to make autonomous decisions based on a clear understanding of their condition, proposed treatments, risks, benefits, and available alternatives. Ethical challenges frequently arise, particularly when patients have impaired decision-making capacity, severe illness, are minors, or when language and cultural barriers hinder effective communication [14]. Regarding professional behavior during patient care, respondents generally emphasized both respect for patient privacy and patient safety. These two principles were simultaneously observed during patient care (62.59%), patient examination (82.99%), and daily hygiene care (75.51%). Access to public hospital services without discrimination was confirmed by 97.28% of respondents. This finding may be explained by the public status of the Regional Hospital of Labé and its role as the major referral hospital for the prefectures within the Labé Administrative Region. These same factors may explain why 80.95% of respondents stated that economically disadvantaged patients receive free medical care. In addition, the Guinean health authorities have established an indigence fund in all public health facilities to support vulnerable patients. Finally, according to the findings of this study, 89.80% of healthcare professionals believed that patient confidentiality is adequately maintained within the Regional Hospital of Labé.

Physicians and nurses are frequently confronted with ethical and legal issues in their daily professional practice. However, many healthcare professionals are either unaware of the importance of these issues or lack the ability to address them appropriately. Since the findings of this study indicate that workplace learning plays an important role in improving knowledge of medical ethics and professional conduct, it is essential to identify healthcare professionals who appear indifferent to ethical and legal issues and to develop effective strategies to raise their awareness in the workplace. Strengthening ethics education, particularly through a multidisciplinary approach, could help bridge the gap in ethical perspectives and practices among physicians, nurses, and patients.

Thierno Mamadou Cherif DIALLO: Conceptualization, methodology, investigation, and manuscript drafting. Namandian TRAORE: Conceptualization, supervision, methodology, and critical revision of the manuscript. Ousmane CAMARA: Methodology, investigation, and review of the manuscript. Ousmane SOUMAH: Data collection, investigation, and manuscript review. Sia Marie OUENDENO: Data collection, investigation, and manuscript review. Djenabou BAH: Data collection, investigation, and manuscript review. Sambou OULARE: Data analysis, interpretation, and manuscript review. Aly Badara CAMARA: Data analysis, interpretation, and manuscript review. Marie Rose LAMAH: Investigation, data collection, and manuscript review. Idiatou BALDE: Investigation, data collection, and manuscript review. All authors read and approved the final manuscript.