[Clinical ethics support with CURA. Acceptability and feasibility among medical practitioners in geriatric and palliative medicine].

Abstract

Introduction: Moral conflicts are common within geriatric and palliative care and can lead to moral distress. Clinical ethics support helps healthcare providers in managing moral conflicts and moral distress. CURA is a low-threshold clinical ethics support instrument. The feasibility for nurses and nurse-assistants in palliative care has already been investigated. However, the acceptability and feasibility of CURA within medical practitioners is unclear.

Methods: Prospective cohort study, using mixed methods. Participants are medical practitioners working in geriatric or palliative care, who attended a workshop on CURA. They received a baseline questionnaire (n=41) after the workshop regarding acceptability and a follow-up questionnaire (n=22) after three months regarding feasibility. Additionally, in-depth interviews (n=7) were conducted.

Results: 68% of participants expressed intention to use CURA at baseline; 32% were uncertain. 14% has actually used CURA after three months. Feasibility is dependent of several factors: (1) recognizing a moral situation; (2) familiarity with the methodology; (3) scheduling a CURA moment; (4) the role of colleagues and the healthcare organization.

Conclusion: Whereas CURA is an acceptable tool for medical practitioners, feasibility is found to be low if practitioners do not receive additional training and support.