Ethical challenges in primary care: a focus group study with general practitioners, nurses and informal caregivers

Abstract

All parties may benefit from ethics support services, a rarity in German primary care so far. Furthermore, nurses' self-confidence towards GPs, demanding patients and family members has to be strengthened. Informal caregivers, the most vulnerable group, need more attendance and tailored support.

Ethical Problems and Moral Distress in Primary Care: A Scoping Review

“…The most productive country was Brazil, with seven studies included [ 20 , 21 , 25 , 26 , 29 , 30 , 32 ]. Two studies were conducted in Canada [ 24 , 33 ]; two in Sweden [ 22 , 23 ]; one each in Germany [ 19 ], the Netherlands [ 28 ], Turkey [ 27 ], and Australia [ 31 ]. The total number of nurses involved in quantitative studies was 1137 (range: 36–433); the total number of nurses involved in qualitative studies was 144 (range: 7–73).…”

“…Gágyor et al [ 19 ], Karlsson et al [ 22 ], and Siqueira-Batista et al [ 20 ] described ethical problems arising in primary care, home care settings, and among family health strategy (FHS) professionals, respectively. According to Karlsson et al [ 22 ], a significant number of the FHS professionals reported no experience with ethical problems during their practice.…”

“…According to Karlsson et al [ 22 ], a significant number of the FHS professionals reported no experience with ethical problems during their practice. On the contrary, poor trust from patients or family members, bureaucratic requirements, financial interests from family members, the need to find a balance between the patients’ integrity and protection and between care obligations and care limits, and fearing the negative consequences of certain actions were the main ethical problems reported among primary care nurses [ 19 ]. Communication with other healthcare professionals (such as physicians or physiotherapists) was also reported to be poor or conflicting [ 19 , 20 , 22 , 31 ].…”

“…On the contrary, poor trust from patients or family members, bureaucratic requirements, financial interests from family members, the need to find a balance between the patients’ integrity and protection and between care obligations and care limits, and fearing the negative consequences of certain actions were the main ethical problems reported among primary care nurses [ 19 ]. Communication with other healthcare professionals (such as physicians or physiotherapists) was also reported to be poor or conflicting [ 19 , 20 , 22 , 31 ]. Nurses “sometimes felt dependent on a family member, a daughter or a son of the patient, who was also involved in patient care” [ 19 ].…”

Segurança do profissional e problemas éticos e bioéticos no cotidiano da atenção primária

“…(11, p. 6-7) Em âmbito internacional, os problemas éticos e bioéticos na aps originam-se de comunicação deficiente, sobrecarga de trabalho, omissões ou erros ligados à assistência, despreparo e insegurança do profissional (12,13). Quando não solucionados ou esquecidos, são capazes de provocar impotências, conflitos e distanciamento entre a identidade pessoal, a ética e o profissional (14).…”