Kirsty Clarke, Karen Borges, Sultan Hatab, Lauren Richardson, Jessica Taylor, Robyn Evans, Bethany Chung, Harriet Cleverdon, Andreas Xyrichis, Amelia Cook, Joel Meyer, Louise Rose
{"title":"Ethical considerations related to virtual visiting for families and critically ill patients in intensive care: a qualitative descriptive study.","authors":"Kirsty Clarke, Karen Borges, Sultan Hatab, Lauren Richardson, Jessica Taylor, Robyn Evans, Bethany Chung, Harriet Cleverdon, Andreas Xyrichis, Amelia Cook, Joel Meyer, Louise Rose","doi":"10.1186/s12910-024-01130-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively.</p><p><strong>Methods: </strong>We used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23-27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach.</p><p><strong>Results: </strong>Five overarching themes emerged. Two of the themes namely, 'fulfilling a moral instinct to connect families' and 'promoting autonomy', arose from participants' descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, 'preserving dignity and privacy', 'managing emotional distress', and 'providing equitable access' to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications.</p><p><strong>Conclusion: </strong>Virtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"25 1","pages":"126"},"PeriodicalIF":3.0000,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549751/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Medical Ethics","FirstCategoryId":"98","ListUrlMain":"https://doi.org/10.1186/s12910-024-01130-z","RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: During the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively.
Methods: We used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23-27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach.
Results: Five overarching themes emerged. Two of the themes namely, 'fulfilling a moral instinct to connect families' and 'promoting autonomy', arose from participants' descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, 'preserving dignity and privacy', 'managing emotional distress', and 'providing equitable access' to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications.
Conclusion: Virtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely.
期刊介绍:
BMC Medical Ethics is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.