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Published on: September 19, 2012
Decision-making at the border of viability by means of values clarification: a case study to achieve distinct
Katharina Paulmichl1, Erna Hattinger-Jürgenssen, Barbara Maier
1Paracelsus Medical School, Salzburg University, Salzburg, Austria. katharina.paulmichl@pmu.ac.at
Objectives:
We set out to investigate the major obstacles in achieving a sensitive and supportive communication between parents and clinicians in ethical dilemma situations. We focused on discussions in emergency situations by means of values clarification.
Methods:
The study population (n=141) covers four samples of clinical staff (n(1)=72) from different specialties and parents of preterm and term infants (n(2)=69). Because of the vulnerability of parents and the virulence of the topic, the descriptive qualitative case study comprises standardized questionnaires and half-standardized interviews. Data were analyzed graphically and statistically, comparing parents and professionals for the justification of acting using values clarification in this context.
Results:
Our study indicated that the use of a critically reconsidered and less personalized language has to be a major goal in the care of preterm infants at the edge of viability. Furthermore we found that acting ethically means making decisions individually by using open-context terms sensitively in consideration of diverging action-guiding principles.
Conclusions:
Decisions in medicine concern different people - experts as well as patients and their representatives. The present study is an attempt to establish more awareness for improved communication, which is a part of professionalism, as well as coping strategies for all involved.
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