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Children's voices on their values and moral dilemmas when being cared and treated for cancer- a qualitative interview
Charlotte Weiner1,2, Pernilla Pergert3,4, Anders Castor5
1Childhood Cancer Research Unit, Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden. charlotte.weiner@ki.se.
Insights
Children undergoing cancer treatment value personal relationships and face moral dilemmas regarding their well-being versus treatment needs. Understanding these values is key to providing ethical support in pediatric cancer care.
Area of Science:
- Pediatric oncology
- Bioethics in childhood cancer care
- Child psychology and well-being
Background:
- Childhood cancers impact approximately 350 children annually in Sweden, posing life-threatening challenges.
- The treatment journey for pediatric cancer patients frequently involves morally challenging situations.
- Identifying children's values and ethical dilemmas is crucial for developing targeted ethics support in cancer care.
Purpose of the Study:
- To explore and understand the core values held by children undergoing cancer treatment.
- To identify and analyze the moral dilemmas encountered by pediatric cancer patients during their treatment.
Main Methods:
- A qualitative study employing content analysis of empirical data.
- Data collected via three focus group interviews and six individual interviews with 16 children (aged 10-18) treated for cancer in Sweden.
- Ethical approval obtained from the Swedish Ethical Review Authority, ensuring voluntary participation with consent/assent.
Main Results:
- Five key value themes emerged: Personal relationships, Bodily ease and identity, Feeling in control and being involved, Positive distractions, and Right care that is needed.
- Moral dilemmas were categorized into: Should I consider others or not? Should I rest or not? and Should I refuse treatment or not?
- Children desire personal relationships with healthcare professionals and grapple with balancing their well-being against treatment demands and others' values.
Conclusions:
- Children undergoing cancer treatment prioritize personal connections with healthcare providers.
- Moral dilemmas stem from conflicts between personal well-being, external expectations, and necessary treatments.
- Further research is essential to develop effective strategies for addressing moral dilemmas in pediatric cancer care.
Background:
Childhood cancers affect about 350 children every year in Sweden and are life-threatening diseases. During the treatment period, situations arise that can become morally challenging for the child. When knowing children's values and morally challenging situations in childhood cancer care, targeted ethics support could be developed and used in care.
Aim:
To explore children's values and moral dilemmas when undergoing cancer treatment.
Methods:
This is a qualitative study based on empirical data. The data collection was conducted through three focus group interviews and six individual interviews with children between 10 and 18 years (n = 16). A content analysis methodology was used to generate themes. Children who were/have been treated for cancer at three childhood cancer centres in Sweden were invited to participate. The study was approved by the Swedish Ethical Review Authority. The children's participation was based on voluntariness and consent/assent.
Findings:
During the analysis, five themes of values emerged: Personal relationships, Bodily ease and identity, Feeling in control and being involved, Positive distractions and Right care that is needed. Their moral dilemmas were thematized into: Should I consider others or not? Should I rest or not? and Should I refuse treatment or not?
Conclusion:
Children undergoing cancer treatment want to have personal relationships with healthcare professionals. Their moral dilemmas were about questioning their own physical and psychological well-being against their expectations, the values of others and the treatment required. Further research is needed to understand how to deal with moral dilemmas in children undergoing cancer treatment.
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