Experiences of ethical issues when caring for children with cancer

Cancer Nurs. 2015 Mar-Apr;38(2):125-32. doi: 10.1097/NCC.0000000000000130.

Abstract

Background: The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethical issues.

Objective: The purpose of this study was to describe healthcare professionals' experiences of ethical issues and ways to deal with these when caring for children with cancer.

Methods: A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories.

Results: The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics.

Implications for practice: Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care.

Conclusions: 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?

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child Health / ethics*
  • Ethics, Nursing*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms*
  • Nursing Staff / ethics
  • Surveys and Questionnaires
  • Sweden