Table 3.

Main themes, subthemes, and final codes

Main themes, subthemes, and final codes
Maine Themes	Subthemes	Final codes
External factors	Poor and irregular monitoring	Lack of monitoring the effectiveness of committees’ approvals
	Lack of integrated instructions	Failure to communicate the regulations of hospital committees by the Ministry of Health to hospitals
Internal factors	Organizational culture	Low and insufficient commitment of senior managers in the implementation of committees’ approvals Lack of appropriate atmosphere in the organization to implement the standards
	Human resources	Low awareness of the committee members about the description of the duties and purposes of the committee Lack of awareness of the hospital staff about professional ethics standards Lack of appropriate incentive and punitive system for the staff in enforcing committee approvals
structure of the ethics committee	The nature of the committee	Overlapping agenda of the medical ethics committee with other hospital committees Uncertainty of the ethics committee’s scope of authority and executive power Ineffective meetings of the ethics committee Lack of transparency of the ethics committee’s mission and goals Lower priority of the ethics committee’s formation process than other hospital tasks
	Ineffectiveness of the committees’ approvals	Low impact of the ethics committees on the implementation of professional ethics Lack of a clear and appropriate mechanism for the appropriate selection of committee members Absence or low attendance of physicians and other committee members in committee meetings Possibility of the ethics committee’s unfair judgments Failure to fully implement committee’s approvals