Ethical Issues faced by Home Care Physicians and Nurses in Japan and their Ethics Support Needs: a Nationwide Survey

Kei Takeshita; Noriko Nagao; Toshihiko Dohzono; Keiko Kamiya; Yasuhiko Miura

doi:10.1007/s41649-023-00238-5

Ethical Issues faced by Home Care Physicians and Nurses in Japan and their Ethics Support Needs: a Nationwide Survey

Asian Bioeth Rev. 2023 Jan 27;15(4):457-477. doi: 10.1007/s41649-023-00238-5. eCollection 2023 Oct.

Authors

Kei Takeshita¹, Noriko Nagao², Toshihiko Dohzono³, Keiko Kamiya⁴, Yasuhiko Miura⁵

Affiliations

¹ Department of Medical Ethics, School of Medicine, Tokai University, Isehara, Kanagawa Prefecture Japan.
² School of Nursing, Kitasato University, Sagamihara, Kanagawa Prefecture Japan.
³ Division of Social and Human Studies, College of Humanities and Social Sciences, Shizuoka University, Shizuoka, Shizuoka Prefecture Japan.
⁴ Kamiya Law Office, Tokyo, Japan.
⁵ Department of General Internal Medicine, The Jikei University Kashiwa Hospital, Kashiwa, Chiba Prefecture Japan.

PMID: 37808443
PMCID: PMC10555967 (available on 2024-10-01)
DOI: 10.1007/s41649-023-00238-5

Abstract

This study aimed to identify the ethical issues faced by home care physicians and nurses, and the support they require. It was conducted in collaboration with the Japanese Association for Home Care Medicine from November to December 2020. An e-mail was sent to 2785 physicians and 582 nurses who are members of the society, requesting their participation in a web-based survey targeting physicians and nurses with practical experience in home care; 152 physicians and 53 nurses responded. Home care physicians and nurses face ethical issues, some of which are that "the patient's wishes cannot be reliably understood owing to their impaired decision-making capacity" and "there is disagreement between the patient and their family members over the necessary healthcare." The respondents sought "experience with, and insight into, healthcare ethics" and "home care" from people with whom they would consult on ethical issues, but at the time of the actual consultation, those individuals were the main healthcare professionals involved with the patient. In addition, the respondents desired to have "multidisciplinary discussions in the community," "participation of healthcare ethics experts at meetings," and "meetings held by healthcare ethics experts" to discuss specific cases. Given these results and the history of healthcare ethics education in Japan-which has been implemented mostly for healthcare providers-we conclude that it is important for academic societies that offer healthcare ethics education to healthcare providers and regional core hospitals with ethics support resources to collaborate to provide ethics consultation services in the community.

Keywords: Ethics consultation; Ethics support; Healthcare ethics; Home care; Nursing.

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