Paediatric Palliative Care in Clinical Practice: Ethical Issues in Advance Care Planning and End-of-Life Decisions

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-04-21 DOI:10.1111/jep.70094

Anamarija Meglič, Ajda Lisec

{"title":"Paediatric Palliative Care in Clinical Practice: Ethical Issues in Advance Care Planning and End-of-Life Decisions","authors":"Anamarija Meglič, Ajda Lisec","doi":"10.1111/jep.70094","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Rationale</h3>\n \n <p>This study examines ethical challenges faced by a paediatric palliative care (PPC) team when making end-of-life (EOL) decisions for children with life-limiting conditions.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>To assess the team's attitudes towards ethical issues and propose innovative solutions.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The data was collected in 2022 at the University Children's Hospital Ljubljana. A researcher-made questionnaire was developed based on team experience. Ten PPC team members participated anonymously, evaluating ethical concerns in communication, decision-making, and patient characteristics. Mann–Whitney <i>U</i> test was used to analyze the data.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Ethical issues emerge when coordinating treatment opinions becomes challenging, resulting in excluding a child from PPC. Situations involving communication, differing healthcare opinions, and patient characteristics were seen as ethical issues, highlighting the importance of communication and shared decision-making.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Ethical complexities in paediatric EOL care require adept communication and interdisciplinary teamwork. Poor communication may be associated with excluding children from PPC. Innovative strategies and ongoing training are vital to address these challenges effectively, ensuring optimal care for children and their families.</p>\n </section>\n </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 3","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70094","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of evaluation in clinical practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jep.70094","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Rationale

This study examines ethical challenges faced by a paediatric palliative care (PPC) team when making end-of-life (EOL) decisions for children with life-limiting conditions.

Aim

To assess the team's attitudes towards ethical issues and propose innovative solutions.

Methods

The data was collected in 2022 at the University Children's Hospital Ljubljana. A researcher-made questionnaire was developed based on team experience. Ten PPC team members participated anonymously, evaluating ethical concerns in communication, decision-making, and patient characteristics. Mann–Whitney U test was used to analyze the data.

Results

Ethical issues emerge when coordinating treatment opinions becomes challenging, resulting in excluding a child from PPC. Situations involving communication, differing healthcare opinions, and patient characteristics were seen as ethical issues, highlighting the importance of communication and shared decision-making.

Conclusions

Ethical complexities in paediatric EOL care require adept communication and interdisciplinary teamwork. Poor communication may be associated with excluding children from PPC. Innovative strategies and ongoing training are vital to address these challenges effectively, ensuring optimal care for children and their families.

查看原文本刊更多论文

临床实践中的儿科姑息关怀：预先护理计划和临终决定中的伦理问题

本研究探讨了儿科姑息治疗（PPC）团队在为生命受限的儿童做出临终（EOL）决定时所面临的伦理挑战。目的评估团队对道德问题的态度，并提出创新的解决方案。方法于2022年在卢布尔雅那大学儿童医院收集数据。研究人员根据团队经验编制了问卷。10名PPC团队成员匿名参与，评估沟通、决策和患者特征方面的伦理问题。采用Mann-Whitney U检验对数据进行分析。结果当协调治疗意见变得具有挑战性时，伦理问题就会出现，导致儿童被排除在PPC之外。涉及沟通、不同医疗保健意见和患者特征的情况被视为道德问题，突出了沟通和共同决策的重要性。结论儿科EOL护理的伦理复杂性需要熟练的沟通和跨学科的团队合作。沟通不良可能与将儿童排除在PPC之外有关。创新战略和持续培训对于有效应对这些挑战、确保儿童及其家庭获得最佳照顾至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.