Healthcare organizations and high profile disagreements

Moore, Bryanna; Lantos, John D.

doi:10.1111/bioe.12670

Cited by 5 publications

(6 citation statements)

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“…Moore and Lantos have analyzed high‐profile disagreements between families and hospitals and noted that many conflicts begin with an SM post that goes “viral,” sometimes unintentionally 29,30 . At least one parent in our study described feeling that her large SM following influenced her daughter's doctors’ willingness to try interventions identified through SM.…”

Section: Discussionmentioning

confidence: 84%

“The stakes could not be higher”: A mixed methods study of parental social media use in pediatric oncology

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Leonhard

Majeski

et al. 2021

Pediatric Blood & Cancer

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Background To describe how parents and families of children with cancer evaluate the benefits and risks of using social media (SM) and how they navigate disagreements between oncologists’ advice and information found on SM. Procedure Parents of children who had been previously diagnosed with cancer, and who had used SM for a purpose related to that child's health were recruited through SM sites and nonprofit organizations across the United States and were invited to complete questionnaires about their experiences using SM; a subset of participants also completed a follow‐up in‐depth interview. Open‐ended responses and interviews were analyzed using thematic analysis. Results Ninety parents completed written questionnaires; 21 completed follow‐up interviews. Seventy percent reported experiencing a situation in which information shared on SM conflicted with information provided by their child's oncologist. Although 86% reported that they discussed the conflicting information with the oncologist and 70% described the oncologist's response as positive, 78% also described ongoing negative feelings about the experience. Parents described openness to discussing SM, honesty, transparency, and humility regarding the limits of medicine, and shared decision‐making regarding information found on SM as increasing their trust in their oncologist. Conclusions Parents offered valuable insights regarding their experiences navigating SM, including eight recommendations for how pediatricians might approach discussing parental SM use. Future studies will evaluate the utility of these recommendations for pediatric clinicians.

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Section: Discussionmentioning

confidence: 84%

“The stakes could not be higher”: A mixed methods study of parental social media use in pediatric oncology

Foot

Leonhard

Majeski

et al. 2021

Pediatric Blood & Cancer

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“…Whether they should seek to engage with international colleagues and advocate strongly for their own clinical position or develop consensus international professional referral standards. Moore and Lantos41 previously suggested that clinicians should use non-adversarial methods—by avoiding ‘fighting back’ with direct approaches, or ‘ducking for cover’ in the face of online scrutiny or critique. Rather, clinicians should share open, optimal information with families to enhance therapeutic alliances, and institutions should harness public relations platforms to promote best practice to the wider health community.…”

Section: Using Ethics Principles and Questions To Navigate The ‘Crowd...mentioning

confidence: 99%

Responding to the ‘crowd’ of voices and opinions in the paediatric clinical space: an ethics perspective

Delany,

Moore,

Bhatia

et al. 2023

Arch Dis Child

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Ready access to the internet and online sources of information about child health and disease has allowed people more ‘distant’ from a child, family and paediatric clinician to inform and influence clinical decisions. It has also allowed parents to share aspects of their child’s health and illness to garner support or funding for treatment. As a consequence, paediatric clinicians must consider and incorporate the crowd of opinions and voices into their clinical and ethical reasoning.We identify two key ethical principles and related ethics concepts foundational to this task. We then propose a series of exploratory ethics questions to assist paediatric clinicians to engage ethically with the multiple voices in the clinical encounter while keeping the child’s needs as a central focus. Using two clinical hypothetical case examples, we illustrate how our proposed ethics questions can assist paediatric clinicians to navigate the crowd in the room and bring moral reasoning to bear.We highlight a need for specific practical interactional skills training to assist clinicians to ethically respond to the crowd in the room, including to identify and weigh up the harms and benefits of endorsing or going against proposed treatments for a child, and how to discuss social media and online sources of information with parents.

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Section: Introductionmentioning

confidence: 99%

“…Yet, a significant concern is that as a result of these high-profile cases and the public disagreements they involved, health professionals may develop reluctance in confronting the reality of futility, when continued intervention may support the wishes of parents. 9,10 In this paper, we seek to offer a pragmatic and accessible approach to understanding how futility is professionally, ethically and legally approached and understood when there are disagreements as to what is in the best interests of the child with a life-limiting condition. It is not our intention to address specific individual issues within the aforementioned cases, but rather explain that these cases have challenged paediatric intensive care practice and therefore that they highlight the importance of moral and ethical reasoning in contextualising futility as an integral part of this complex area of clinical care.…”

Section: Introductionmentioning

confidence: 99%

Children, futility and parental disagreement: The importance of ethical reasoning for clinicians in the paediatric intensive care setting

Baiocchi

Horowicz

2022

Clinical Ethics

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The provision of intensive care enables the lives of neonates, infants and children to be sustained or extended in circumstances previously regarded as impossible. However, as well as benefits, such care may confer burdens that resultingly frame continuation of certain interventions as futile, conferring more harm than or any, benefit. Subsequently, clinicians and families in the paediatric intensive care unit are often faced with decisions to withdraw, withhold or limit intensive care in order to act in the best interests of the child. An integral consideration in respect of these decisions is that futility is a concept that has to be contextualised for all those involved. Recent high-profile legal cases highlight the professional, clinical, legal and social conflicts that can arise when parents and clinicians have different interpretations of futility. In acknowledging the complexity of these conflicts for clinicians, this paper aims to support a better understanding of futility as an integral concept in such difficult and emotive decisions within professional practice. We utilise the concept of futility to frame how these decisions to withdraw or withhold certain invasive life-prolonging interventions are ethically and legally justifiable, even when they disagree or conflict with parental views. To support clinicians in understanding these decisions, we in part use the familiar bioethical framework of Principlism developed by Beauchamp and Childress. We suggest that understanding legal and ethical analysis of futility ultimately will help clinicians in approaching and reflecting on such decision-making.

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Healthcare organizations and high profile disagreements

Cited by 5 publications

References 0 publications

“The stakes could not be higher”: A mixed methods study of parental social media use in pediatric oncology

“The stakes could not be higher”: A mixed methods study of parental social media use in pediatric oncology

Responding to the ‘crowd’ of voices and opinions in the paediatric clinical space: an ethics perspective

Children, futility and parental disagreement: The importance of ethical reasoning for clinicians in the paediatric intensive care setting

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