SynthesisPalliative medicine2021
Real-world ethics in palliative care: A systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice.
Synthesis in Palliative medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Ethical perspectives in palliative care for chronic patients: a systematic review of nurses' experiences in home and hospital settings.BMC palliative care · 2026Pooled it
- What Is a Good Death in South Asia? A Systematic Review and Narrative Synthesis.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2025Pooled it
- Ethical, legal, and social aspects of health technologies for home-based paediatric palliative care - a systematic review.BMC palliative care · 2025Pooled it
- Increasing the chance of dying at home: roles, tasks and approaches of general practitioners enabling palliative care: a systematic review of qualitative literature.BMC primary care · 2023Pooled it
- Hope and despair in cancer and other illnesses: a clinical framework for adaptive hope across the illness trajectory.ESMO open · 2026Review
- Gender-sensitive and diversity-sensitive end-of-life care in Switzerland (GiveCare): a mixed-methods study protocol.BMJ open · 2026Article
- Ethics based educational interventions on end-of-life care for undergraduate nursing students: A scoping review.International journal of nursing studies advances · 2026Review
- Addressing the critical palliative care gaps in ethnic minority regions of low- and middle-income countries: a focus group study.BMC medicine · 2026Article
- Ethical considerations of AI integration in palliative care: a qualitative study.BMC palliative care · 2026Article
- Perceived readiness for clinical practice among recent graduates of a 5 + 2 reformed medical curriculum.BMC medical education · 2026Article
- Healthcare professionals' perceptions of ethical issues in palliative sedation: A moral case deliberation study in eight European countries.Palliative care and social practice · 2026Article
- Legal and ethical conflicts in hospital settings: thematic synthesis of qualitative studies focused on nursing practice.BMC medical ethics · 2025Article
- Assessing nursing students' palliative care training needs and profiles: a cross-sectional study using K-means clustering.BMC nursing · 2025Article
- Public Perspectives on Palliative and Hospice Care: Social Media Content Analysis Using Topic Modeling and Multiclass Sentiment Analysis.Journal of medical Internet research · 2025Article
- Palliative Care as a Predictor of Professional Stress and Mental Health in Nurses: A Cross-Sectional Study.Nursing open · 2025Article
- Moral courage of palliative care nurses and affecting factors.BMC palliative care · 2025Article
- Paediatric Palliative Care in Clinical Practice: Ethical Issues in Advance Care Planning and End-of-Life Decisions.Journal of evaluation in clinical practice · 2025Article
- Nursing contribution to end-of-life care decision-making in patients with neurological diseases on an acute hospital ward: documentation of signs and symptoms.BMC nursing · 2025Article
- Ethical reflection: The palliative care ethos and patients who refuse information.Palliative care and social practice · 2025Article
- A pragmatic approach to selecting a grading system for clinical practice recommendations in palliative care.Palliative medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundEthical issues arise daily in the delivery of palliative care. Despite much (largely theoretical) literature, evidence from specialist palliative care practitioners about day-to-day ethical challenges has not previously been synthesised. This evidence is crucial to inform education and adequately support staff.
aimTo synthesise the evidence regarding the ethical challenges which specialist palliative care practitioners encounter during clinical practice.
designSystematic review with narrative synthesis (PROSPERO registration CRD42018105365). Quality was dual-assessed using the Mixed-Methods Appraisal Tool. Tabulation, textural description, concept mapping and thematic synthesis were used to develop and present the narrative. DATA SOURCES: Seven databases (MEDLINE, Philosopher's Index, EMBASE, PsycINFO, LILACS, Web of Science and CINAHL) were searched from inception to December 2019 without language limits. Eligible papers reported original research using inductive methods to describe practitioner-reported ethical challenges.
resultsA total of 8074 records were screened. Thirteen studies from nine countries were included. Challenges were organised into six themes: application of ethical principles; delivering clinical care; working with families; engaging with institutional structures and values; navigating societal values and expectations; philosophy of palliative care. Challenges related to specific scenarios/contexts rather than the application of general ethical principles, and occurred at all levels (bedside, institution, society, policy).
conclusionPalliative care practitioners encounter a broad range of contextual ethical challenges, many of which are not represented in palliative care ethics training resources, for example, navigating institutional policies, resource allocation and inter-professional conflict. Findings have implications for supporting ethical practice and training practitioners. The lack of low- and middle- income country data needs addressing.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.