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Experiences of ethical issues when caring for children with cancer
Cecilia Bartholdson1, Kim Lützén, Klas Blomgren
1Author Affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Insights
Healthcare professionals face ethical challenges in pediatric cancer care, including autonomy concerns and treatment decisions. Improved interprofessional collaboration and dedicated ethics reflection time are crucial for better outcomes.
Area of Science:
- Pediatric Oncology
- Bioethics
- Healthcare Professional Experience
Background:
- Pediatric cancer treatment presents significant physical, social, and psychological burdens.
- Ethical issues frequently arise during the care of children with cancer.
Purpose of the Study:
- To explore healthcare professionals' experiences with ethical issues in pediatric cancer care.
- To identify strategies used by professionals to manage these ethical challenges.
Main Methods:
- Qualitative content analysis of a study-specific questionnaire administered to healthcare professionals at a Swedish pediatric hospital.
- Inductive coding of data to generate categories and subcategories related to ethical concerns and coping mechanisms.
Main Results:
- Key ethical issues identified include infringing on patient autonomy, determining treatment intensity, and managing conflicting professional perspectives.
- Professionals expressed a need for enhanced teamwork, dedicated time for ethical reflection, and access to resources to address ethical dilemmas.
Conclusions:
- There is a need to improve interprofessional collaboration and provide structured forums for ethical reflection in pediatric cancer care.
- Addressing ethical concerns, including conflicting perspectives and parental involvement, is essential for developing a holistic ethical approach.
Background:
The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethical issues.
Objective:
The purpose of this study was to describe healthcare professionals' experiences of ethical issues and ways to deal with these when caring for children with cancer.
Methods:
A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories.
Results:
The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics.
Implications For Practice:
Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care.
Conclusions:
Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents' involvement be "turned around," that is, contribute to a holistic perspective of ethics in cancer care of children?
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