Decision-making at the border of viability by means of values clarification: a case study to achieve distinct communication by ordinary language approach

Abstract

We set out to investigate the major obstacles in achieving a sensitive and supportive communication between parents and clinicians in ethical dilemma situations. We focused on discussions in emergency situations by means of values clarification. The study population (n=141) covers four samples of clinical staff (n(1)=72) from different specialties and parents of preterm and term infants (n(2)=69). Because of the vulnerability of parents and the virulence of the topic, the descriptive qualitative case study comprises standardized questionnaires and half-standardized interviews. Data were analyzed graphically and statistically, comparing parents and professionals for the justification of acting using values clarification in this context. Our study indicated that the use of a critically reconsidered and less personalized language has to be a major goal in the care of preterm infants at the edge of viability. Furthermore we found that acting ethically means making decisions individually by using open-context terms sensitively in consideration of diverging action-guiding principles. Decisions in medicine concern different people - experts as well as patients and their representatives. The present study is an attempt to establish more awareness for improved communication, which is a part of professionalism, as well as coping strategies for all involved.