Clinician and carer moral concerns when caring for children who tube-feed

J Child Health Care. 2023 Jun;27(2):182-196. doi: 10.1177/13674935211052842. Epub 2021 Oct 26.

Abstract

Child healthcare can be vexed by moral concerns - this extends to the care of children who tube-feed. Children who tube-feed often receive care from family members and clinicians of various disciplines. Each brings expertise, experiences, values, and views to a situation, prioritising the child's needs while attending to those they deem important in potentially disparate ways. Their understanding of a situation is shaped by beliefs, feelings, and perceptions. How then are key decisions made about the care of a child who tube-feeds? This article explores clinicians' and carers' moral concerns when caring for children who tube-feed. Interviews with clinicians (n = 9) and carers (n = 9) clarified three findings: first, there are often disparate beliefs about the need for tube-feeding; second, tube-feeding can evoke strong emotions; and third, it can be difficult to normalise tube-feeding. This article demonstrates how challenges can emerge when relationships between clinicians and carers diverge. Furthermore, it establishes how an ethic of care can bring different interests together to bolster the relationships required to optimise feeding care and promote health outcomes among children who tube-feed and their carers. This requires improved dialogue between and among clinicians and carers to create shared understandings of what is, what should be, and how to benefit children who tube-feed.

Keywords: Child health; enteral nutrition; feeding and eating disorders; morals; qualitative research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Caregivers* / psychology
  • Child
  • Enteral Nutrition
  • Family / psychology
  • Health Promotion*
  • Humans
  • Morals