Abstract
This study aimed to identify the ethical issues faced by home care physicians and nurses, and the support they require. It was conducted in collaboration with the Japanese Association for Home Care Medicine from November to December 2020. An e-mail was sent to 2785 physicians and 582 nurses who are members of the society, requesting their participation in a web-based survey targeting physicians and nurses with practical experience in home care; 152 physicians and 53 nurses responded. Home care physicians and nurses face ethical issues, some of which are that “the patient’s wishes cannot be reliably understood owing to their impaired decision-making capacity” and “there is disagreement between the patient and their family members over the necessary healthcare.” The respondents sought “experience with, and insight into, healthcare ethics” and “home care” from people with whom they would consult on ethical issues, but at the time of the actual consultation, those individuals were the main healthcare professionals involved with the patient. In addition, the respondents desired to have “multidisciplinary discussions in the community,” “participation of healthcare ethics experts at meetings,” and “meetings held by healthcare ethics experts” to discuss specific cases. Given these results and the history of healthcare ethics education in Japan—which has been implemented mostly for healthcare providers—we conclude that it is important for academic societies that offer healthcare ethics education to healthcare providers and regional core hospitals with ethics support resources to collaborate to provide ethics consultation services in the community.
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Data Availability
The data of this study are available from the corresponding author upon reasonable request. All data are in Japanese.
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Acknowledgements
We are sincerely grateful to the Japanese Association for Home Care Medicine for their generous cooperation in conducting this study. We would like to thank Editage (www.editage.com) for English language editing.
Funding
This work was supported by the Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research (JSPS KAKENHI Grant), #19K10543.
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Kei Takeshita contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by Kei Takeshita and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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We obtained ethical approval from the Institutional Review Board for Clinical Research of the Tokai University School of Medicine (20R240) on 16 November 2020.
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In the cover letter to the questionnaire, we explained that participation was voluntary and that by responding, the participants were providing their consent to take part in the study, and that the data obtained would be published in academic communities.
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Takeshita, K., Nagao, N., Dohzono, T. et al. Ethical Issues faced by Home Care Physicians and Nurses in Japan and their Ethics Support Needs: a Nationwide Survey. ABR 15, 457–477 (2023). https://doi.org/10.1007/s41649-023-00238-5
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DOI: https://doi.org/10.1007/s41649-023-00238-5