Ethical and Legal Issues in Palliative Care

McCabe, Mary S.; Coyle, Nessa

doi:10.1016/j.soncn.2014.08.011

Cited by 10 publications

(7 citation statements)

References 22 publications

(21 reference statements)

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“…In the context of palliative and end-of-life care, FC may encounter manifold morally distressing problems or ethical dilemmas. These, among others, include withholding/ withdrawing of treatment, nutrition and hydration, resuscitation orders, palliative sedation, and truthful communication [16,17].…”

Section: Introductionmentioning

confidence: 99%

Ethical challenges in family caregivers of patients with advanced cancer – a qualitative study

et al. 2020

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Background: Caring for patients with advanced or terminal diseases can confront family caregivers (FC) with ethical challenges. The present study aims at tracing paths connected to ethical challenges among FC of advanced cancer patients by exploring morally troubling situations and related burden, as well as strategies to handle the situation and experience of moral distress from the grieving FC's perspective. Methods: Within a qualitative design, interviews with 12 grieving FC were conducted using a semi-structured interview guide. Data were analysed using grounded theory and abductive reasoning. Results: Core phenomena identified were two paths connected to ethical challenges among FC. Ethical challenges occurred in the context of difficult decision-making (Path 1) and in the context of lacking decision-making options when no decision was to be made by FC (Path 2). We found each path to be triggered by distinct sets of morally troubling situations that occurred during the patient's disease trajectory. In the course of difficult decision-making (Path 1), detrimental external factors could add emotional stress, thus making the decision-making process burdensome. FC used various proactive strategies to overcome those detrimental factors and/or to make the decision. Decisions in conflict with FCs' own moral expectations and values led to moral distress, generating painful emotions. When no decision was to be made by FC (Path 2), FC felt powerless and overrun, which was associated with major emotionality in terms of anxiety and confusion. Either detrimental factors aggravated these feelings to paralyzing shock, or internal resources enabled FC to accept the situation. While acceptance prevented moral distress, paralyzing shock often caused a sense of not meeting their their own moral expectations and values, resulting in moral distress. In both paths, factors were identified that helped FC finding closure and prevented moral residue. Nevertheless, some FC experienced residual moral distress months after the morally troubling situation had occurred. Conclusion: Findings provide first information towards understanding paths leading to ethical challenges in FC and can help clinicians to minimize associated emotional burden and moral distress.

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Section: Introductionmentioning

confidence: 99%

Ethical challenges in family caregivers of patients with advanced cancer – a qualitative study

et al. 2020

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“…After reviewing and evaluating the quali ed articles, the ndings were classi ed into four main categories as follows: 1) Nature, 2) Applicability, 3) Relevant and in uential factors, and 4) Challenges related to the ethical principle of bene cence in nursing care (Table 2). -The core of care [20] -Ethical commitment to the bene t for patients [39] Applicability -No harm to the patient(nonmale cence) [12,16,22,26,[34][35][36][37][38]40] -Improving the well-being of patients [20,22,24,25,37,38] -Attention to patient's preferences and needs[16, 25,34,41] -justice-fair distribution of resources [20,24,35] -protection of patient safety [24,37,40] -Predicting and reducing pain [12,41] -Palliative and end of life care [38,41] -Patient Safety [24,37] -Health Promotion [22,34] - -Organizational ethical climate in the implementation of bene cence [37] Challenges -Lack of acquainted with the de nition of bene cence concept [42] -Applicability of bene cence [24,25,34] -Con ict between bene cence and preservation of patient autonomy[16, 22,…”

Section: Resultsmentioning

confidence: 99%

The principle of beneficence in nursing care: an integrative review

Valizadeh

Zamanzadeh

Cheraghi

et al. 2022

Preprint

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Background: Ethics-based nursing practice can transform health care practices. As the biggest human capital in the health care system, nurses are obliged to follow the ethical principles in this field. One of these ethical principles; is beneficence, which is considered the core of nursing care. This study aimed to investigate the ethical principle of beneficence in nursing care and its related challenges. Methods: This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of science, PubMed, and Scopus were searched using the keywords; "beneficence", "ethic", "nursing" and "care" in English and Persian. After applying inclusion criteria and assessing the articles using Bowling's Quality Assessment Tool, finally, 16 papers were included from 957. Results: After reviewing and evaluating the qualified articles, the findings were classified into four main categories: 1) nature, 2) applicability, 3) Relevant and influential factors, and 4) challenges related to the ethical principle of beneficence in nursing care. Conclusion: Based on the results of this review it seems that paying attention to training to the principle of beneficence in nursing care can provide positive outcomes for patients to benefit from this principle and finally, it leads to increasing the well-being and health of patients, reducing their mortality rate, increasing satisfaction and maintaining the respect and human dignity of patients.

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“…This cultural congruence is important given that Latinas may struggle to navigate the health care system and deal with language barriers during health care interactions, and that their cancer experience is often shaped by cultural values such as familism, relating to strong identification with one's nuclear and extended family. In the cancer care setting, constructs such as familism are the norm to put the survivors' comfort and needs above the needs of the cosurviving other family members and make treatment decisions at the family rather than individual level . While a focus on survivors' comfort is justified, Abrazo focuses on the family supporting the survivor.…”

Section: Discussionmentioning

confidence: 99%

“…In the cancer care setting, constructs such as familism are the norm to put the survivors’ comfort and needs above the needs of the co-surviving other family members and make treatment decisions at the family rather than individual level. 39,40 While a focus on survivors’ comfort is justified, Abrazo focuses on the family supporting the survivor. In a clinical setting, this support may be particularly important for family-centered care if the family does not have the cancer knowledge or self-confidence to fully participate in treatment decision making.…”

Section: Discussionmentioning

confidence: 99%

Oregon's Familias en Acción replicates benefits for underserved cancer co‐survivors through Un Abrazo Para la Familia

Marshall

Curran

Brownmiller³

et al. 2018

Psycho-Oncology

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Our replication study provides a useful roadmap for others focusing on the psychosocial needs of Hispanic/Latino cosurviving family members of cancer. A manualized 12-hour training program based on the initial discovery and efficacy work was developed to train promotoras as a part of this study. The manual provides a clear protocol for others to replicate our intervention and evaluation procedures. Abrazo may be particularly important for family-centered care if the family does not have the cancer knowledge or self-confidence needed to fully participate.

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Ethical and Legal Issues in Palliative Care

Cited by 10 publications

References 22 publications

Ethical challenges in family caregivers of patients with advanced cancer – a qualitative study

Ethical challenges in family caregivers of patients with advanced cancer – a qualitative study

The principle of beneficence in nursing care: an integrative review

Oregon's Familias en Acción replicates benefits for underserved cancer co‐survivors through Un Abrazo Para la Familia

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