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The challenges of ethical deliberation in palliative care settings: A descriptive study

Published online by Cambridge University Press:  11 August 2021

Serge Dumont ,
Véronique Turcotte Open the ORCID record for Véronique Turcotte [Opens in a new window] ,
Michèle Aubin ,
Lynn Casimiro ,
Mireille Lavoie  and
Louise Picard
Serge Dumont*
Affiliation:
School of Social Work and Criminology, Faculty of Social Sciences, Laval University, Quebec City, QC, Canada VITAM-Research Centre for Sustainable Health, Quebec City, QC, Canada Laval University Cancer Research Centre, Quebec City, QC, Canada
Véronique Turcotte
Affiliation:
Laval University Cancer Research Centre, Quebec City, QC, Canada
Michèle Aubin
Affiliation:
VITAM-Research Centre for Sustainable Health, Quebec City, QC, Canada Laval University Cancer Research Centre, Quebec City, QC, Canada Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada
Lynn Casimiro
Affiliation:
La Cité Collégiale, Ottawa, ON, Canada
Mireille Lavoie
Affiliation:
Laval University Cancer Research Centre, Quebec City, QC, Canada Faculty of Nursing, Laval University, Quebec City, QC, Canada
Louise Picard
Affiliation:
School of Social Work and Criminology, Faculty of Social Sciences, Laval University, Quebec City, QC, Canada Laval University Cancer Research Centre, Quebec City, QC, Canada
*
Author for correspondence: Serge Dumont, School of Social Work and Criminology, Pavillon Charles-de-Koninck, Laval University, 1030, av. des Sciences-Humaines, Québec, QC, Canada G1V 0A6. E-mail: serge.dumont.1@ulaval.ca
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Abstract

Objective

Inadequate deliberation processes about ethical problems occurring in palliative care settings may negatively impact both patients and healthcare professionals. Better knowledge of the palliative care professionals’ practices regarding such processes could help identify specific education needs to improve the quality of palliative care in the context of complex ethical situations. Therefore, this descriptive study aimed to (1) examine ethical deliberation processes in interprofessional teams in five palliative care settings; (2) identify organizational factors that constrain such processes; and (3) based on this knowledge, identify priority education needs for future and current palliative care professionals.

Method

The study involved three data collection activities: (1) direct observation of simulated interprofessional ethical deliberations in various palliative care settings; (2) individual semi-structured interviews; and (3) deliberative dialogues.

Results

Thirty-six healthcare professionals took part in the simulated ethical deliberations and in the deliberative dialogue activities, and 13 were met in an individual interview. The study results revealed suboptimal interprofessional collaboration and ethical deliberation competencies, particularly regarding awareness of the ethical issue under consideration, clarification of conflicting values, reasonable decision making, and implementation planning. Participants also reported facing serious organizational constraints that challenged ethical deliberation processes.

Significance of results

This study confirmed the need for professional education in interprofessional collaboration and ethical deliberation so that palliative care professionals can adequately face current and future ethical challenges. It also enabled the identification of educational priorities in this regard. Future research should focus on identifying promising educational activities, assessing their effectiveness, and measuring their impact on patient and family experience and the quality of palliative care.

Keywords

Decision makingEducationEthicsInterprofessional collaborationPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 2 , April 2022 , pp. 212 - 220
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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