Evidence map›Paper›PMID 34583710›Full record

ArticleBMC medical ethics2021

Factors influencing practitioners' who do not participate in ethically complex, legally available care: scoping review.

Janine Brown, Donna Goodridge, Lilian Thorpe, Alexandra Hodson, Mary Chipanshi

Abstract readScoping Review
In one paragraph

Article in BMC medical ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Janine BrownFaculty of Nursing, University of Regina, 111-116 Research Drive, Saskatoon, SK, S7N 3R3, Canada.
Donna GoodridgeCollege of Medicine, University of Saskatchewan, E1216, Health Sciences Building, 104 Clinic Place, Saskatoon, SK, S7N 5E5, Canada. donna.goodridge@usask.ca.ORCID 0000-0002-8680-8646
Lilian ThorpeDepartments of Community Health and Epidemiology and Psychiatry, University of Saskatchewan, E3218, Health Sciences Building, 104 Clinic Place, Saskatoon, SK, S7N 5E5, Canada.
Alexandra HodsonFaculty of Nursing, University of Regina, 111-116 Research Drive, Saskatoon, SK, S7N 3R3, Canada.
Mary ChipanshiNursing Liaison Librarian, University of Regina Library, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients' healthcare options and influence healthcare practitioners' (HCPs') practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.

methodsWe used Arksey and O'Malley's framework while considering Levac et al.'s enhancements, and qualitatively synthesized the evidence. We searched Medline, CINAHL, JSTOR, EMBASE, PsychINFO, Sociological Abstracts, and ProQuest Dissertations and Theses Global from January 1, 1998, to January 15, 2020, and reviewed the references of the final articles. We included articles written in English that discussed the factors that influenced physicians and registered nurses (RNs) who did not participate in end-of-life (EOL), reproductive technology and health, genetic testing, and organ or tissue donation healthcare areas. Using Covidence, we conducted title and abstract screening, followed by full-text screening against our eligibility criteria. We extracted the article's data into a spreadsheet, analyzed the articles, and completed a qualitative content analysis using NVivo12.

resultsWe identified 10,664 articles through the search, and after the screening, 16 articles were included. The articles sampled RNs (n = 5) and physicians (n = 11) and encompassed qualitative (n = 7), quantitative (n = 7), and mixed (n = 2) methodologies. The care areas included reproductive technology and health (n = 11), EOL (n = 3), organ procurement (n = 1), and genetic testing (n = 1). One article included two care areas; EOL and reproductive health. The themed factors that influenced HCPs who did not participate in healthcare were: (1) HCPs' characteristics, (2) personal beliefs, (3) professional ethos, 4) emotional labour considerations, and (5) system and clinical practice considerations.

conclusionThe factors that influenced HCPs' who did not participate in ethically complex, legally available care are diverse. There is a need to recognize conscientious objection to healthcare as a separate construct from non-participation in healthcare for reasons other than conscience. Understanding these separate constructs will support HCPs' specific to the underlying factors influencing their practice participation.

Indexed as

ConsciencePhysiciansDelivery of Health CareHealth FacilitiesHumansAbstentionCare provisionConscientious objectionMedical ethicsNon-involvementNon-participationRefusal to treat

Identifiers

PMID34583710
PMCPMC8479895

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.