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Ethical Dilemmas I01:17

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Ethical dilemmas in nursing are of utmost importance, as they often arise from the tension between adhering to core ethical principles and the practical realities of healthcare delivery. These dilemmas require nurses to navigate complex situations where competing ethical considerations pull them in different directions.
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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
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Pediatric Ethics Consultation Services, Scope, and Staffing.

Meaghann S Weaver1,2, Shiven Sharma3, Jennifer K Walter4,3

  • 1Pediatric Palliative Care, University of Nebraska Medical Center, Omaha, Nebraska.

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Pediatric ethics consultation services (PECS) show wide variation in staffing and funding. Many children

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Area of Science:

  • Pediatric healthcare ethics
  • Clinical ethics consultation services
  • Hospital administration and policy

Background:

  • National guidelines emphasize the need for ethical conflict resolution in children's hospitals.
  • The scope and structure of pediatric ethics consultation services (PECS) are not well-defined.
  • Understanding current PECS practices is crucial for developing standardized approaches.

Purpose of the Study:

  • To quantify the staffing, structure, function, scope, training, and funding of PECS in children's hospitals.
  • To identify variations in PECS across different institutions.
  • To assess the resources allocated to pediatric ethics support.

Main Methods:

  • A cross-sectional online survey was distributed to ethics informants at 181 children's hospitals in the US.
  • Data collection occurred between March and June 2022.
  • Descriptive statistics and semantic content analyses were used to summarize survey responses.

Main Results:

  • 104 children's hospitals completed the survey (65% response rate).
  • Significant variation exists in PECS staffing (average 7.4 responsible individuals) and funding (median 0.25 FTE support, 33% with no salary support).
  • Common consult themes include end-of-life care, treatment benefits/burdens, and staff moral distress; 21% of hospitals receive no patient/family consults.

Conclusions:

  • Pediatric ethics consultation services exhibit considerable variability in their operational models and resource allocation.
  • A significant lack of financial and institutional support for PECS is evident, despite considerable consultation volumes.
  • These findings highlight a critical need for improved support and standardization of PECS to address ethical challenges in pediatric care.