Screening situations for risk of ethical conflicts: a pilot study

Area of Science:

• Medical Ethics
• Nursing Practice
• Healthcare Management

Background:

• Ethical conflicts in healthcare settings can negatively impact teamwork and cause moral distress for patients, families, and providers.
• A proactive strategy for managing ethical conflicts is essential for enhancing patient care outcomes.
• Identifying and addressing ethical challenges early can mitigate adverse effects on all stakeholders.

Purpose of the Study:

• To evaluate the acceptability and feasibility of an ethics screening and early intervention tool.
• To assess the tool's utility for nurses caring for critically ill patients.

Main Methods:

• Twenty-eight nurses utilized the ethics screening tool across 55 patient cases in two medical centers.
• Nurses identified risk factors and early indicators of ethical conflicts, categorizing situations by risk level.
• Qualitative data were gathered through focus groups and content analysis of nurses' explanations.

Main Results:

• Older patients with multiple comorbidities and aggressive treatments were often identified as high-risk for ethical conflicts.
• Patient suffering, unrealistic family expectations, and provider moral distress were key indicators of ethical conflict.
• High-risk situations exhibited a greater number of identified risk factors and early indicators compared to lower-risk situations.

Conclusions:

• The study identified a phenomenon of shared suffering, highlighting the need for relational approaches.
• Routine family conferences and ethics consultations are recommended as effective strategies.
• Implementing ethics screening tools can support nurses in managing complex ethical situations.