Financial toxicity

Ethical and Policy Implications of Financial Burden in Family Caregivers

“…Screening for insurance; access to financial support through local, state, and federal resources; employment and employment needs; and financial well-being all need to be integrated into chronic disease management for ethical care of both the care recipient and caregiver. 21 M.T.H., from the case example, experienced positive and negative examples of support for her family's financial needs. Some positive examples include the pharmacist who printed off a coupon and applied it to her daughter's prescription without being asked; the nurse who went out of her way to coordinate imaging and evaluations for the same week to limit their travel and M.T.H.…”

“…19 These actions also demonstrate the impact of health care professionals who work within and beyond the scope of their job description to make a difference for the financial well-being of family caregivers. 21…”

“…Possible nursing interventions to address financial burden in family caregivers include the following: financial toxicity screening; education about community resources to support employment, FMLA or other paid leave benefits, insurance access, medication assistance programs, and organizational charity care options; referral coordination to social work and financial advisors for additional resource support; empowerment of family caregivers through discussion of resources and creative approaches to meeting financial obligations through resource utilization; and advocacy at the organizational, community, state, and federal levels for policies that support paid family leave for family caregivers, employment protection for family caregivers, health insurance and treatment access, and services and supports for family caregivers. 21 These measures recommended by the Helping States Support Families Caring for an Aging America are an excellent guide for nursing policy advocacy 28 :…”

“…Along with these broad principles, the American Nurses Association has outlined the Nursing Code of Ethics that includes provisions for the promotion of human dignity; the commitment of nurses to the patient (whether the patient is an individual, family, or community); advocacy for the rights, safety, and health of patients; collaboration with other health professionals to reduce health disparities; and integration of social justice into nursing and health policy 20 . These ethical principles directly apply to the financial burden and needs of family caregivers including promoting the well-being of the care recipient and caregiver (facilitating access to care and resources for both parties), preventing harm related to financial burden (eg, forgone care for caregiver or care recipient or decreased access to treatments), 10 providing resources and support that expand treatment options and facilitate patient and caregiver decision-making, and support of those patients and caregivers who are most at risk for financial challenges due to social determinants of health 10,21,22 . Ethical issues of access, equitable treatment and outcomes, and holistic health and well-being 21,23 impact caregivers and patients experiencing financial toxicity over the course of chronic disease.…”

“…These ethical principles directly apply to the financial burden and needs of family caregivers including promoting the well-being of the care recipient and caregiver (facilitating access to care and resources for both parties), preventing harm related to financial burden (eg, forgone care for caregiver or care recipient or decreased access to treatments), 10 providing resources and support that expand treatment options and facilitate patient and caregiver decision-making, and support of those patients and caregivers who are most at risk for financial challenges due to social determinants of health 10,21,22 . Ethical issues of access, equitable treatment and outcomes, and holistic health and well-being 21,23 impact caregivers and patients experiencing financial toxicity over the course of chronic disease. Screening for insurance; access to financial support through local, state, and federal resources; employment and employment needs; and financial well-being all need to be integrated into chronic disease management for ethical care of both the care recipient and caregiver 21 …”