How paediatric nurses frame the ethics of non-disclosure directives

Area of Science:

• Pediatric Nursing
• Bioethics
• Child Advocacy

Background:

• Non-disclosure directives in adult care raise ethical concerns regarding patient autonomy.
• Withholding information from children presents unique ethical challenges, with less existing literature.
• Nurses are pivotal in advocating for children's rights and best interests.

Purpose of the Study:

• To explore nurses' experiences and attitudes toward truth-telling with seriously ill children.
• To understand how nurses perceive and navigate ethical dilemmas when directed not to disclose information to pediatric patients.
• To investigate the ethical challenges faced by nurses regarding non-disclosure directives in pediatric care.

Main Methods:

• Interpretive phenomenological approach.
• Data collected through semi-structured interviews with 26 nurses in Australia.
• Participants had cared for hospitalized children with serious illnesses within the last 5 years.

Main Results:

• Four key themes emerged: 'Lying is wrong,' 'Children should know,' 'It's hard for us when the child doesn't know,' and 'It's not our place to tell.'
• Nurses expressed a belief in honesty and the importance of children knowing their medical status.
• Participants described the impact of non-disclosure directives on their patient care practices.

Conclusions:

• Nurses advocate for honesty but feel unable to initiate truth-telling when parents direct otherwise.
• Ethical support and inclusion in decision-making processes are recommended for nurses facing these challenging situations.
• Strengthening nurses' capacity to navigate ethical complexities in pediatric non-disclosure is crucial for upholding children's rights.