Seeing several sides of the story: Unpacking an ethical dilemma in home-based care

IF 1.8 3区社会学 Q2 GERONTOLOGY

Journal of Aging Studies Pub Date : 2025-04-06 DOI:10.1016/j.jaging.2025.101323

Cecilie Knagenhjelm Hertzberg, Morten Magelssen, Anne Kari Tolo Heggestad

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引用次数: 0

Abstract

Healthcare professionals in home-based care face various challenges at the system and patient levels, which can lead to ethical dilemmas. In addition, home-based care workers lack arenas to share their experiences, as they are often scattered across the care district, work alone, and do not have the immediate support of a colleague. Based on ethnographic fieldwork among professional caregivers in home-based care in Norway, we present a case of an ethical dilemma that occurred during a patient visit. Using a narrative ethics approach, we unpack the case into six “stories” and show the context of the ethical dilemma. Home-based care staff may not be aware of an ethical dilemma as it unfolds. Reflection on the case leads us to suggest that staff would benefit from some form of clinical ethics support to learn, share stories, and receive support. We also suggest that professional caregivers and patients would benefit from advance care planning as a way to clarify expectations between patients and healthcare professionals. Clinical ethics support and advance care planning are ways for staff and patients, respectively, to let their voices and stories be heard.

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看到故事的多个侧面：解读家庭护理中的道德难题

从事居家护理的医护人员面临着系统和患者层面的各种挑战，这可能会导致伦理困境。此外，居家护理人员缺乏分享经验的场所，因为他们往往分散在不同的护理区，独自工作，没有同事的直接支持。基于对挪威居家护理专业护理人员的人种学实地调查，我们介绍了一个在探访病人时发生的伦理困境案例。我们采用叙事伦理方法，将该案例分解为六个 "故事"，并展示了伦理困境的来龙去脉。家庭护理人员可能不会意识到道德困境的发生。通过对案例的反思，我们认为员工可以从某种形式的临床伦理支持中获益，从而学习、分享故事并获得支持。我们还建议，专业护理人员和患者可以从预先护理规划中获益，从而明确患者和医护人员之间的期望。临床伦理支持和预先护理规划分别是员工和患者倾诉心声和故事的途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Aging Studies GERONTOLOGY-

CiteScore

3.20

自引率

17.40%

发文量

审稿时长

50 days

期刊介绍： The Journal of Aging Studies features scholarly papers offering new interpretations that challenge existing theory and empirical work. Articles need not deal with the field of aging as a whole, but with any defensibly relevant topic pertinent to the aging experience and related to the broad concerns and subject matter of the social and behavioral sciences and the humanities. The journal emphasizes innovations and critique - new directions in general - regardless of theoretical or methodological orientation or academic discipline. Critical, empirical, or theoretical contributions are welcome.