The evolution of a long-term care ethics committee

Sansone, Paulette

doi:10.1007/bf00057975

Cited by 7 publications

(9 citation statements)

References 3 publications

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“…It is thus obvious that ethical issues are frequent and important for most people working in nursing homes. Compared with studies from other countries, ethical challenges in Norwegian nursing homes in general are not very different from those reported in the literature . But it is striking that the lack of resources is the most frequently mentioned ethical challenge in a wealthy country such as Norway.…”

Section: Discussionmentioning

confidence: 62%

“…Many ethical challenges in the care of the elderly and in nursing homes have been reported in the literature. These include, for example, decision‐making and other challenges in end‐of‐life care , use of restraints , lack of resources , autonomy and decision‐making capacity , communication and cooperation between healthcare workers and the patients’ next of kin and the resident's privacy and behaviour . It seems useful to distinguish between ethical challenges and ethical dilemmas in nursing home care.…”

Section: Introductionmentioning

confidence: 99%

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Ethical challenges in nursing homes – staff's opinions and experiences with systematic ethics meetings with participation of residents’ relatives

Bollig

Schmidt

Rosland

et al. 2015

Scandinavian Caring Sciences

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Background Many ethical problems exist in nursing homes. These include, for example, decision‐making in end‐of‐life care, use of restraints and a lack of resources. Aims The aim of the present study was to investigate nursing home staffs’ opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes. Methods The study used a two‐tiered approach, using a questionnaire on ethical challenges and systematic ethics work, given to all employees of a Norwegian nursing home including nonmedical personnel, and a registration of systematic ethics discussions from an Austrian model of good clinical practice. Results Ninety‐one per cent of the nursing home staff described ethical problems as a burden. Ninety per cent experienced ethical problems in their daily work. The top three ethical challenges reported by the nursing home staff were as follows: lack of resources (79%), end‐of‐life issues (39%) and coercion (33%). To improve systematic ethics work, most employees suggested ethics education (86%) and time for ethics discussion (82%). Of 33 documented ethics meetings from Austria during a 1‐year period, 29 were prospective resident ethics meetings where decisions for a resident had to be made. Agreement about a solution was reached in all 29 cases, and this consensus was put into practice in all cases. Residents did not participate in the meetings, while relatives participated in a majority of case discussions. In many cases, the main topic was end‐of‐life care and life‐prolonging treatment. Conclusions Lack of resources, end‐of‐life issues and coercion were ethical challenges most often reported by nursing home staff. The staff would appreciate systematic ethics work to aid decision‐making. Resident ethics meetings can help to reach consensus in decision‐making for nursing home patients. In the future, residents’ participation should be encouraged whenever possible.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Ethical challenges in nursing homes – staff's opinions and experiences with systematic ethics meetings with participation of residents’ relatives

Bollig

Schmidt

Rosland

et al. 2015

Scandinavian Caring Sciences

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“…Most CECs will consider exceptional issues like Do Not Resuscitate orders, patient competence, the use of feeding tubes or the use of restraints 9. A number of CECs pay explicit attention to everyday ethical issues 16 18 19. One article pictures the shift that the particular ethics study group made from a focus on end-of-life, medical decision issues to the ordinary, everyday events of resident life.…”

Section: Resultsmentioning

confidence: 99%

Ethics support in institutional elderly care: a review of the literature

et al. 2014

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Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases (Pubmed, CINAHL/PsycINFO, Ethxweb). Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: 'institutional bodies' (ethics committee and consultation team); 'frameworks' (analytical tools to assist care professionals); 'educational programmes and moral case deliberation'; and 'written documents and policies'. For each category the goals, methods and ways of organising are described. Ethics support often serves several goals and can be targeted at various levels: case, professional or organisation. Over the past decades a number of changes have taken place in the development of ethics support in elderly care. Considering the goals, ethics support has become more outreaching and proactive, aiming to qualify professionals to integrate ethics in daily care processes. The approaches in clinical ethics support have become more diverse, more focused on everyday ethical issues and better adapted to the concrete learning style of the nursing staff. Ethics support has become less centrally organised and more connected to local contexts and primary process within the organisation.

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“…Ethical problems in nursing homes are often more complex than those in hospitals [7,18,19]. There are two major groups of ethical issues in nursing homes.…”

Section: Ethical Challenges and Dilemmas In Nursing Homesmentioning

confidence: 99%

“…"Respect for individual persons is the ethical thread that runs through the care of nursing home residents." [1] There are many ethical challenges in nursing homes, for example a lack of resources, coercion, autonomy, decision-making for residents without capacity, and end-of-life care issues [2][3][4][5][6][7][8][9][10][11]. Modern medicine has led to complex ethical challenges because of a greater number of people living with chronic illnesses, and the possibility to extend life using continually invasive therapies such as tube feeding, dialysis and respiratory therapy -even at home [12].…”

Section: Introductionmentioning

confidence: 99%

How to implement systematic ethics work in nursing homes?

Bollig¹,

Rosland²,

Heller³

2016

ame

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Systematic ethics work and ethics discussions may help practitioners handle the many ethical challenges and dilemmas that have been described in the scientific literature pertaining to nursing homes. This review is based on a selective literature search of relevant publications retrieved from PubMed and CINAHL. In addition, relevant articles from the Internet or reference lists of articles and books, and other sources were included. Several methods and ways of approaching the discussion of ethics, and the implementation of ethics work in nursing homes, were identified. Frequently used methods and models to address ethical challenges were ethics peer groups, ethics consultation, or ethics committees. In conclusion, systematic ethics work in nursing homes is needed. The implementation should be individualized to meet different needs, as well as geographical and cultural conditions.

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The evolution of a long-term care ethics committee

Cited by 7 publications

References 3 publications

Ethical challenges in nursing homes – staff's opinions and experiences with systematic ethics meetings with participation of residents’ relatives

Ethical challenges in nursing homes – staff's opinions and experiences with systematic ethics meetings with participation of residents’ relatives

Ethics support in institutional elderly care: a review of the literature

How to implement systematic ethics work in nursing homes?

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