Does participation in ethics discussions have an impact on ethics decision-making? A cross-sectional study among healthcare professionals in paediatric oncology. (June 2021)

• Record Type: Journal Article
• Authors: Bartholdson, Cecilia; Sandeberg, Margareta af; Molewijk, Bert; Pergert, Pernilla
• Is Part Of: European journal of oncology nursing. Volume 52(2021)
• Publication Date: 2021-06
• Subjects: Ethics -- Discussions -- Decision-making -- Paediatric oncology -- Support -- Survey; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2021.101950
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: The overall aim of this study was to describe perceptions of the decision-making process in relation to participation/non-participation in ethics discussions among healthcare professionals in paediatric oncology. Methods: Healthcare professionals, working at three paediatric units where ethics discussions where performed answered a study-specific questionnaire focusing on perceptions of involvement, influence, responsibility and understanding of ethics decision-making. Statistical analyses included descriptive statistics, non-parametric paired t-tests and correlation tests. Results: Participation in ethics discussions was related to perceptions of greater involvement and the possibility of influencing decisions, as well as formal/shared responsibility for the ethics decisions related to patient care. Medical doctors and registered nurses perception of involvement in decisions, possibility to influence and responsibility decreased when they were not present during the ethics discussion or when no ethics discussion was conducted at all. Healthcare professionals had a generally good understanding of the ethical issues and the ethics decisions. The whole group considered medical doctors to be the most important participants in the ethics discussions, followed by patients/family. Healthcare professionals wanted more teamwork and viewed ethics discussions as very helpful for teamwork when dealing with ethical issues in paediatric oncology. Conclusions: Ethics discussions in paediatric oncology practice increases the involvement within and the understanding of the decision-making process about ethical decisions. The understanding is not always dependent on participation, indicating a great trust in team members. Based on these findings the implementation of a structure for ethics support in paediatric oncology where patients/families are integrated is recommended. Highlights: Existing research knowledge. Ethics discussions can increase mutual understanding, consolidate care, and facilitate ethical decision making New knowledge added Participation in ethics discussion was related to perceptions of greater involvement in the decisions and responsibility MDs' and RNs' perception of involvement in decisions and responsibility decreased when they were not present Healthcare professionals had a high degree of understanding of the decision made during an ethics discussion