Exploring ethical dilemmas in pediatric oncology nursing: A qualitative approach

BackgroundEthical dilemmas in pediatric oncology represent a major challenge for nurses, significantly impacting their well-being and motivation at work.Research aimThe objective of this study was to identify the ethical dilemmas experienced by nurses through a sample recruited from two pediatric cancer treatment units.Research designThis study adopts an interpretative phenomenological qualitative approach based on interviews conducted with nurses working in pediatric oncology.Ethical considerationsThe study adhered to ethical principles. Institutional authorization was obtained prior to data collection, and participants' confidentiality and anonymity were strictly ensured.FindingsThe findings revealed that nurses face ethical dilemmas on a daily basis, structured around four main thematic domains: communication and decision-making, pain and care practices, professional integrity and safety, and systemic and contextual constraints. These dilemmas encompass issues such as truth-telling, treatment refusal, pain management, medication errors, resource allocation, confidentiality, and end-of-life decisions, including treatment futility. These situations have a significant impact on nurses' well-being and on the quality of care provided.Discussion and conclusionOur findings align with international literature, highlighting that poor service management, institutional conflicts, heavy workloads, and unrealistic expectations from some families also contribute to the psychological and moral distress of nurses. This study underscores the need to implement support mechanisms to help nurses navigate ethical dilemmas. Improving healthcare organization, providing continuous training, and ensuring appropriate supervision could reduce moral distress among caregivers and enhance the quality of care for children with cancer.