Journal of Medical Ethics 47 (12):47-47 (2021)

Abstract
Communicating an unfavourable prognosis while maintaining patient hope represents a critical challenge for healthcare professionals. Duty requires respect for the right to patient autonomy while at the same time not doing harm by causing hopelessness and demoralisation. In some cases, the need for therapeutic privilege is discussed. The primary objectives of this study were to explore HPs’ perceptions of hope in the prognosis communication and investigate how they interpret and operationalise key ethical principles. Sixteen qualitative semistructured interviews with HPs from different positions and experience, including doctors and nurses in four different departments, were conducted in the Ticino Cantonal Hospital, Switzerland. The interviews were recorded, transcribed verbatim and analysed using thematic analysis. HPs defined prognosis and patient hope as interdependent concepts related to future perspectives for subjective quality of life. Two main factors allow HPs to maximise the benefits and minimise the harm of their communication: respecting the patient’s timing and sharing the patient’s wishes. Time is required to reframe needs and expectations. Furthermore, communication needs to be shared by HPs, patients and their relatives to build common awareness and promote a person-centred approach to prognosis. In this process, interprofessional collaboration is key: doctors and nurses are complementary and can together guarantee that patients and relatives receive information in the most appropriate form when they need it. Organisational aspects and the HPs’ emotional difficulties, particularly in coping with their own despair, are barriers to effective communication that need further investigation.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/medethics-2020-106157
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 68,975
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Is There a Problem With False Hope?Bert Musschenga - 2019 - Journal of Medicine and Philosophy 44 (4):423-441.

View all 10 references / Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles

The Perils of Hope.Lawrence Schneiderman - 2005 - Cambridge Quarterly of Healthcare Ethics 14 (2):235-239.
The Perils of Hope.Lawrence J. Schneiderman - 2005 - Cambridge Quarterly of Healthcare Ethics 14 (2):235-239.
Prognosis Terminal: Truth-Telling in the Context of End-of-Life Care.Ben A. Rich - 2014 - Cambridge Quarterly of Healthcare Ethics 23 (2):209-219.
A Paradox of Hope? Toward a Feminist Approach to Palliation.Allison Merrick - 2016 - International Journal of Feminist Approaches to Bioethics 9 (1):104-120.

Analytics

Added to PP index
2020-10-15

Total views
5 ( #1,198,603 of 2,498,184 )

Recent downloads (6 months)
2 ( #282,957 of 2,498,184 )

How can I increase my downloads?

Downloads

My notes