Ethical Issues In Palliative Care Research Articles

Modules From the End-of-Life Nursing Education Consortium: Japan Core Curriculum Necessary for Second- to Fourth-Year Nurses as Assessed by Advanced Practice Registered Nurses.

This study aimed to identify the modules of the End-of-Life Nursing Education Consortium-Japan Core Curriculum (ELNEC-J), which are particularly necessary for second- to fourth-year nurses. This cross-sectional study recruited certified nurse specialists in cancer nursing (CNSCNs) endorsed by the Japanese Nursing Association enrolled in Advanced Practice Registered Nurses (APRNs) in Japan. We asked individuals who were active members of the volunteer association of CNSCNs in the Tokai region to participate via email, and we collected data using Google Forms. The participants were asked about their background, including APRN experience and current position. Furthermore, we asked them to select three necessary modules for second- to fourth-year nurses' education from the 10 modules of the ELNEC-J. The study recruited a total of 19 (89%) APRNs (response rate: 100%). Out of them, 14 (73.6%) had more than six years of clinical experience in APRNs, and 12 (63.1%) held managerial positions. Regarding the 10 modules of the ELNEC-J, the responses for the necessary modules were as follows: nursing care at end-of-life 13 (68.4%), pain management 12 (63.2%), symptom management 10 (52.6%), communication 10 (52.6%), and ethical issues in palliative care nursing five (31.6%). According to the perspective of APRNs responsible for palliative care education for incumbent nurses, nursing care at the end of life, pain management, symptom management, and communication are required for second- to fourth-year nurse education.

Ethical issues in nursing home palliative care: a cross-national survey

ObjectivesWith an increased dependency on nursing homes to provide care to the ageing population, it is likely that ethical issues will also increase. This study aimed to identify the type...

Ethical issues experienced during palliative care provision in nursing homes.

Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context. To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom. Exploratory, sequential, mixed-methods design. Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The 'Ethical Issues in Palliative Care for Nursing Homes' instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015. Ethical approval was granted by Queen's University's School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home's manager. The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress. The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate=33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles.

Ethical Issues In Palliative Care

Ethical Issues In Palliative Care

MORECare research methods guidance development: Recommendations for ethical issues inpalliative and end-of-life care research

Background: There is little guidance on the particular ethical concerns that research raises with apalliative care population. Aim: To present the process and outcomes of a workshop and consensus exercise on agreed best practiceto accommodate ethical issues in research on palliative care. Design: Consultation workshop using the MORECare Transparent Expert Consultation approach. Prior toworkshops, participants were sent overviews of ethical issues in palliative care. Following theworkshop, nominal group techniques were used to produce candidate recommendations. These were ratedonline by participating experts. Descriptive statistics were used to analyse agreement andconsensus. Narrative comments were collated. Setting/participants: Experts in ethical issues and palliative care research were invited to the Cicely SaundersInstitute in London. They included senior researchers, service providers, commissioners,researchers, members of ethics committees and policy makers. Results: The workshop comprised 28 participants. A total of 16 recommendations were developed. There washigh agreement on the issue of research participation and high to moderate agreement on applicationsto research ethics committees. The recommendations on obtaining and maintaining consent frompatients and families were the most contentious. Nine recommendations were refined on the basis ofthe comments from the online consultation. Conclusions: The culture surrounding palliative care research needs to change by fostering collaborativeapproaches between all those involved in the research process. Changes to the legal frameworkgoverning the research process are required to enhance the ethical conduct of research in palliativecare. The recommendations are relevant to all areas of research involving vulnerable adults.

Cuidados paliativos oncológicos: tendências da produção científica

Este estudo tem como objetivo identificar as tendências de produção científica a cerca do tema cuidados paliativos oncológicos. Foi construído por meio de revisão integrativa da literatura realizada em busca eletrônica pela Biblioteca Virtual de Saúde – BVS nas bases de dados Literatura Americana e do Caribe em Ciências da Saúde – LILACS, Scientific Electronic Library – SCIELO e Literatura Internacional em Ciências da Saúde – MEDLINE. Os dados foram agrupados em quatro categorias temáticas: as questões éticas nos cuidados paliativos, o impacto da terminalidade na vida do indivíduo, a qualidade de vida nos cuidados paliativos e cuidado paliativo domiciliar. Com isso procede-se a discussão de conceito de cuidados paliativos na oncologia e as questões complexas que envolvem a temática, como a ética e a morte. Contudo, aponta os desafios do sistema de saúde e dos profissionais para discussão e implementação de políticas e serviços de saúde para o cuidado de pacientes terminais.

Clinical and Ethical Issues in Palliative Care and Dementia—An Overview

The prevalence of dementia across Europe and the world is increasing. People die with and from dementia and, as such, advanced dementia can be considered a terminal condition. This, alongside the realization that care for people with dementia is deficient, has led to increasing interest in palliative care in dementia. Palliative care can be a rather broad term with different meanings, but nonetheless guidelines and expert opinions have been developed with the aim of improving overall care for people with dementia. Although at times the evidence on which these guidelines are based is somewhat sparse, they provide guidance in specific areas relevant to dementia. The main areas covered are pain, infection and fevers, artificial nutrition and hydration, resuscitation, and psychological, social, and spiritual needs. We shall consider the evidence on which guidance is based and then highlight a recent ethical framework developed to help thinking around the issues that arise in dementia care.

Clinical and Ethical Issues in Palliative Care and Dementia - An Overview

The prevalence of dementia across Europe and the world is increasing. People die with and from dementia and, as such, advanced dementia can be considered a terminal condition. This, alongside the realisation that care for people with dementia is deficient, has led to increasing interest in palliative care in dementia. Palliative care can be a rather broad term with different meanings, but nonetheless guidelines and expert opinions have been developed with the aim of improving overall care for people with dementia. Although at times the evidence on which these guidelines are based is somewhat sparse, they provide guidance in specific areas relevant to dementia. The main areas covered are pain, infection and fevers, artificial nutrition and hydration, resuscitation and psychological, social and spiritual needs. We shall consider the evidence on which guidance is based and then highlight a recent ethical framework developed to help thinking around the issues that arise in dementia care.

Ethical Issues in Palliative Care

Ethics involves critical reflection on morality. Ethical principles are not laws, but guiding principles about what is ‘good’ and what is ‘bad’, that should direct doctors and other health care professionals in their work and decision making. Issues arising over end-of-life care involving decisions that affect the nature and timing of an individual's death raise difficult ethical conflicts for all concerned and can be a source of discord between health professionals within a team, health professionals and family members, or between different family members. It is not possible to explore all aspects of such decisions, so this article aims to address just the common issues likely to affect GPs on a day-to-day basis.

Clinical and Ethical Issues in Palliative Care

Over the past 15 years, in response to widely-recognized gaps in the care of patients at the end of life, palliative care has emerged as a recognized subspecialty, focused on the care of patients with advanced, progressive, life-threatening illness. The aim of palliative care is to optimize the quality of life for the patient and family through the provision of expert interdisciplinary care, including symptom assessment and treatment, psychosocial and spiritual support to the patient and family, help with complex decisions about treatment options, coordination of care in the community, and bereavement care for families. A growing evidence base demonstrates the effectiveness of palliative care clinical programs in improving symptoms, quality of life, communication, concordance between patient wishes and care received, family satisfaction, and bereavement outcomes and in reducing costs. There are many opportunities for psychiatrists to contribute to care for patients at the end of life through enhanced involvement in palliative care teams.

Ethical Issues in Palliative Care (second edition)

Ethical Issues in Palliative Care (second edition)

Ethical issues in palliative care

To review important issues that address respect for patient autonomy, beneficnce, non-maleficence, and justice, which are included in communication surrounding the determination of decision-making capacity, informed consent, breaking bad news, and creating shared goals of care. Review articles, and government and organizational reports. Palliative care and its proximity to end-of-life care issues frequently raises ethical issues for patients, their families, and the clinicians caring for them. Supporting the identification and honoring the patient's preferences for treatment are central components of ethical behavior. Advance care planning provides an important opportunity for respecting patient autonomy and may be helpful when discussing care options surrounding resuscitation, withholding or withdrawal of treatment, or the determination of medical futility.

Postgraduate diploma in the ethics of cancer and palliative care

Who's it for? Anyone interested in the ethical issues in palliative care, including doctors, nurses, social workers, and chaplains. Designed for people who work full time. When did you do it? 2002, in my first year of specialist registrar training. Why did you do it? There are lots of ethical issues in palliative care. I wanted to improve my decision making skills when facing the …

Ethical issues in palliative care

Most aspects of health care raise moral problems. Ethical issues in palliative care are particularly pressing because they are often literally matters of life and death. Is it right to tell dying patients the truth about their condition, when doing so may cause them terrible distress? Can we justify withholding the truth from them, if they seem not to want to hear it? Can it ever be right to let a patient die?

Ethical Issues in Palliative Care

Ethical Issues in Palliative Care

Ethical Issues in Palliative Care

Discussions on ethics in palliative care often concentrate on issues like patient autonomy or euthanasia. However, the reality in the developing world begs discussion on an entirely different set of problems altogether. One should have a good death, no doubt, but one should also have an opportunity for a good life. Globalization unfortunately seems to worsen many of the burdens of the developing world, like the negative influence of the mighty pharmaceutical industry. Continuing medical education offered only by the pharmaceutical industry instills bias into the minds of most medical professionals. Prescription practices by many professionals are influenced by the industry; so much so, inexpensive drugs or formulations are abandoned in favor of expensive ones, adding to the burden of a much-suffering individual. Palliative care should have been a major force against such evils, but it seems to get more clinical and institutionalized with time, with the social issues taking a back seat. Unethical research practices and preferential treatment in drug availability are practices that continue to marginalize the less privileged. Adoption of the dominant ideology from the West in the developing world also raises problems like cultural unsuitability. Considering that the bulk of the suffering in the world is in poorer countries, these issues need to be addressed.

Book Reviews

This is the 11th book in Open University Press’s Facing Death series, and is another excellent text. It stems in large part from the work of the Pallium project, a multiprofessional, seven-country project examining conceptual and ethical issues in palliative care across Europe. As might be expected from such a project, the result is a complex and detailed book, which, although not an easy read, is enormously interesting and repays repeated reading.

Book Review: Ethical issues in palliative care: reflections and considerations

Book Review: Ethical issues in palliative care: reflections and considerations

Ethical issues in palliative care

Ethical issues are a constant companion and a constant challenge to those who provide palliative care throughout the world. Opportunities for learning how to deal with ethical issues regularly present themselves in our day-to-day work. Those who have travelled to different countries as part of their work will have learned how political, economic and religious differences influence the way in which ethical issues are approached and resolved.