Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 19;25(1):20.
doi: 10.1186/s12910-024-01017-z.

The role of bioethics services in paediatric intensive care units: a qualitative descriptive study

Denise Alexander  1 , Mary Quirke  1 , Jo Greene  2 , Lorna Cassidy  1 , Carol Hilliard  3 , Maria Brenner  4
Affiliations

The role of bioethics services in paediatric intensive care units: a qualitative descriptive study

Denise Alexander et al. BMC Med Ethics. .

Abstract

Background: There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care.

Methods: A qualitative descriptive design was used to describe clinician's perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis.

Results: From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork.

Conclusions: Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU.

Keywords: Child; Clinical bioethics; Functionality; Innovation; Invasive long-term ventilation; Technology dependence.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Themes mapped against Rogers’ Theory of Diffusion of Innovation [15]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Nathanson PG, Walter JK, McKlindon DD, Feudtner C. Relational, emotional, and pragmatic attributes of Ethics consultations at a children’s hospital. Pediatrics. 2021;147:e20201087. doi: 10.1542/peds.2020-1087. - DOI - PMC - PubMed
    1. Moon M, AAP Committee on Bioethics Institutional Ethics Committees Pediatr. 2019;143:e20190659. doi: 10.1542/peds.2019-0659. - DOI - PubMed
    1. Bester JC. The best interest standard and children: clarifying a concept and responding to its critics. J Med Ethics. 2019;45:117–24. doi: 10.1136/medethics-2018-105036. - DOI - PubMed
    1. Foc G, Hellmann J, Greenberg RA. Parental Moral Distress and Moral Schism in the neonatal ICU. Bioethical Inq. 2018;15:319–25. doi: 10.1007/s11673-018-9858-5. - DOI - PubMed
    1. McDougall R, Notini L, Phillips J. Conflicts between parents and Health professionals about a child’s Medical Treatment: using clinical Ethics records to find gaps in the Bioethics Literature. Bioethical Inq. 2015;12:429–36. doi: 10.1007/s11673-015-9643-7. - DOI - PubMed

Publication types

LinkOut - more resources