Confl icting Values: A Case Study in Patient Choice and Caregiver Perspectives

Decisions related to births in the "gray zone" of periviability are particularly challenging. Despite published management guidelines, clinicians and families struggle to negotiate care management plans. Stakeholders must reconcile conflicting values in the context of evolving circumstance...

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Bibliographic Details
Published in:Narrative inquiry in bioethics 2015-07, Vol.5 (2), p.167
Main Authors: Eves, Margot M, Danziger, Phoebe Day, Farrell, Ruth M, Cole, Cristie M
Format: Article
Language:English
Subjects:
Abortion
Bias
Births
Caregivers
Case studies
Decision making
Ethics
Health care
Health care policy
Hospitals
Impact analysis
Medical ethics
Nursing
Patients
Pregnancy
Professional ethics
Professionals
Psychiatrists
Values
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Summary:Decisions related to births in the "gray zone" of periviability are particularly challenging. Despite published management guidelines, clinicians and families struggle to negotiate care management plans. Stakeholders must reconcile conflicting values in the context of evolving circumstances with a high degree of uncertainty within a short time period. Even skilled clinicians may struggle to guide the patient in making value-laden decisions without imposing their own values. Exploring the experiences of one pregnant woman and her caregivers, this case study highlights how bias may undermine caregivers' ability to meet their obligation to enhance patient autonomy and the moral distress they may experience when a patient's values do not align with their own. Management strategies to mitigate the potential impact of bias and related moral distress are identified. The authors then describe one management strategy used in this case, facilitated ethics consultation, which is focused on thoughtful consideration of the patient's perspective.
ISSN:2157-1732
2157-1740