Managing ethical aspects of advance directives in emergency care services

Background:In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient’s advance directives and implement them.Objectives:To analyse the barriers, facilitators, and ethical conflicts perceived by heal...

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Authors: Poveda-Moral, Silvia (Author) ; Rodríguez-Martín, Dolors (Author) ; Codern-Bové, Núria (Author) ; José-María, Pilar (Author) ; Sánchez-Valero, Pere (Author) ; Pomares-Quintana, Núria (Author) ; Vicente-García, Mireia (Author) ; Falcó-Pegueroles, Anna (Author)
Tipo de documento: Recurso Electrónico Artigo
Idioma:Inglês
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Publicado em: Sage 2021
Em: Nursing ethics
Ano: 2021, Volume: 28, Número: 1, Páginas: 91-105
Outras palavras-chave:B Barriers
B Emergency services
B ethical conflicts
B Advance Directives
Acesso em linha: Volltext (Resolving-System)
Descrição
Resumo:Background:In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient’s advance directives and implement them.Objectives:To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services.Research design, participants, and context:This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency Medical Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis.Ethical considerations:This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients’ anonymity and willingness to participate in the study were guaranteed.Findings:There were four types of barriers that hindered the proper management of patients’ advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals’ decision-making.Discussion:These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals’ beliefs and the opinions of colleagues and family members, can also influence the professionals’ final decisions.Conclusion:The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated.
ISSN:1477-0989
Obras secundárias:Enthalten in: Nursing ethics
Persistent identifiers:DOI: 10.1177/0969733020952112