Experiences of Ethical Issues When Caring for Children With Cancer

Abstract

Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents' involvement be "turned around," that is, contribute to a holistic perspective of ethics in cancer care of children?

Healthcare staff ’s experience in providing end-of-life care to children: A mixed-method review

“…12 Although communication between colleagues was evaluated as good by hospice staff in one study, 38 communication difficulties between colleagues, management and multi-disciplinary teams were referred to as a major source of stress in other studies within the hospital, community and hospice setting. 9,6,12,38,44 This often led to lower job satisfaction, 38 and discontinuity of care. 25 The current system also presented challenges for hospice staff who felt referrals happened too late, mostly due to inadequate cross-sector understanding of availability and content of hospice care, and ineffective multi-disciplinary working.…”

“…Studies were predominantly qualitative (n=18), 6,11,26,28,30,[31][32][33][34][35]37,39,41,43,[45][46][47][48] with a smaller number of quantitative (n=6) 21,25,27,32,38,42 and mixed-method studies (n=8). 5,9,12,29,31,37,40,44 Five quantitative studies were cross-sectional, and one used a pre-post survey design.…”

“…The majority of studies were conducted in the USA (10) 5,25,[29][30][31][32]35,[40][41][42] with the remaining 21 studies carried out in the United Kingdom (6), 11,12,43,45,47,48 Canada (3), 21,37,39 Australia (2), 27,34 Poland (1), 38 Greece (1), 44 Greece and Hong Kong (1), 9 Sweden (2), 6,33 Ireland (2), 28,47 Finland (1), 36 and Switzerland (1). 26 The majority of studies considered nursing staff only (15), 9,11,25,27,30,[32][33][34][35][39][40][41]45,47,48 while others con...…”

“…5 The majority of studies were conducted in a hospital setting (22). 5,6,9,21,[25][26][27][28][29][30][31][32][33][34][35][36][37]39,40,42,44,45 The remaining studies were conducted across a range of settings such as hospital, hospice and community (3), 11,23,41 community only (4) 38,43,47,48 or hospice only (1). 12 A summary of the aims, sample, setting, design and relevant findings from included studies are presented in Table 2.…”

“…5 Paediatric care is unique because of the need to have parents/guardians involved in caring procedures and decision making, while also taking due cognisance of the child's right to have their views and wishes respected according to their level of development and independence. 6 Paediatric palliative care is defined as 'the active total care of the child's body, mind and spirit' 7 .…”