Ethical Dilemmas in Audiology: A Comparative Analysis of Perspectives from the Middle East, North Africa, and the United States.

PURPOSE: The current study aimed to identify the ethical sensitivity of audiologists in Arabic-speaking countries of the Middle East and North Africa (MENA) and compare it with audiologists in the United States (U.S.) as reported in the 2002 and 2006 studies by Hawkins and colleagues. METHODS: In a cross-sectional survey, 123 audiologists from different countries in the MENA region were surveyed on their ethical perspectives regarding 18 ethical situations. An online survey was designed and posted in Arabic using the Qualtrics platform. The link to the survey was distributed via email to audiology providers in the MENA countries, as well as via social media to professional audiology groups. RESULTS: The ethical sensitivity of MENA audiologists based on the ethical sensitivity criteria used in the present study was: 1) emerging for Q1, Q3, Q4, and low for Q2 in the "Business Incentives from Hearing Aid Manufacturers" category, 2) emerging for Q8 and low for Q5, Q6, Q7, Q9, Q10 in the "Entertainment, Small Gifts, and Visits from Manufacturer Representatives" category, 3) low for all questions Q11, Q12, Q13, Q14 in the "Continuing Education Unit Events Sponsored by Hearing Aid Manufacturers" category, and 4) emerging for Q15 and low for Q16, Q17 in the "Business Practices" category. Also, Q18 in the business practices section revealed emerging ethical sensitivity among MENA audiologists toward paying referral fees to physicians. Significant differences in ethical perception were found between the MENA audiologists and their U.S. counterparts across multiple situations in all four domains, with MENA audiologists generally showing lower ethical sensitivity, particularly in relation to professional development opportunities and manufacturer relationships. CONCLUSIONS: Despite the temporal discrepancy between the contemporary MENA data and historical U.S. data, this study establishes a baseline for understanding the ethical landscape of audiology in the MENA region. Our comparison with historical U.S. data revealed significant regional differences in ethical sensitivity, particularly regarding interactions with hearing aid manufacturers and business practices. These findings underscore an urgent need for the development of culturally sensitive ethics education and stronger professional oversight within the MENA region.