Knowledge and practice of healthcare ethics among doctors and nurses in two Ghanaian hospitals: a comparative cross-sectional study

Ethical practice is central to patient trust, safety, and quality healthcare delivery. This study compared healthcare ethics knowledge and practice among doctors and nurses in two Ghanaian hospitals and identified factors associated with ethical practice. An analytical cross-sectional study was conducted among 382 doctors and nurses in two government hospitals in Ghana. Data were collected using a structured questionnaire assessing healthcare ethics knowledge and self-reported practice. Bivariate analysis was conducted using Chi-square tests and T-tests, while Random Forest analysis was applied to identify variables of relative importance to healthcare ethics (HCE) practice. No statistically significant differences were observed between facilities in mean healthcare ethics knowledge (26.3 ± 2.83; p = 0.98) and practice (23.5 ± 2.94; p = 0.16) scores. Healthcare ethics knowledge was significantly positively associated with practice (p < 0.05). Random Forest analysis identified age, knowledge, education, and gender as the most important predictors of ethical practice based on variable importance rankings, with differences observed in their relative contribution across facilities. Healthcare professionals demonstrated moderate-to-high knowledge and practice of healthcare ethics, with no significant institutional differences. Ethical practice was influenced by demographic and educational factors, highlighting the need for context-specific strategies. Strengthening ethical decision-making may require integrating structured and continuous ethics training into professional development, alongside mentorship approaches that reinforce ethical standards in clinical practice. • Bivariate analysis was conducted using Chi-square tests and T-tests, while Random Forest analysis was applied to identify variables of relative importance to healthcare ethics practice. • There are no significant differences in knowledge or practice for healthcare ethics between health facilities • Age, knowledge, education, and facility type were predictors of healthcare ethics practice. • Facility-specific ethics training programs are essential for bridging the gap between knowledge and practice in healthcare ethics. • Incorporating ethics education into ongoing professional development programs is crucial to enhancing ethical decision-making skills among healthcare professionals.