ArticleBMC medical ethics2025
Mapping ethical issues encompassing end-of-life care for persons experiencing severe and persistent mental illness: a qualitative study.
Article in BMC medical ethics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- At the threshold of care: Palliative ethics in severe mental illness.Palliative & supportive care · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundPersons experiencing severe and persistent mental illness (SPMI) represent a small but vulnerable group in mental health care and society. Research on this population is limited, despite significant ethical challenges in their care. These challenges include the severity of their illness, limited social networks, communication difficulties, impaired decision-making capacity, and, at times, disruptive behavior. PURPOSE: This study aims to explore the ethical themes that emerge in the care of persons experiencing SPMI, both in general and at the end of life. Specifically, we examine which issues arise, how care teams address ethical dilemmas, who is involved in decision-making, and what ethical frameworks or practices are utilized.
methodsWe conducted 73 in-depth qualitative interviews with care users, family members, caregivers, care managers, and experts from the Flemish region of Belgium. The data were analyzed through content analysis to identify recurring themes and reflect on ethical practices.
resultsThe findings reveal that while many facilities have ethical guidelines or advisory structures such as ethics committees, these are often not well known or not perceived as easily accessible to frontline staff. Ethical dilemmas are predominantly addressed at the team level, with some organizations employing a reference person ethics in the unit, "ethics pubs", or peer support mechanisms for challenging situations. The most frequently mentioned ethical issue was euthanasia, whereas others included neglect in home settings, prolonged delays in initiating palliative care, and maintaining autonomy for care users. Resource allocation, both at the organizational and societal levels, was also identified as an ethical concern. Caregivers described tensions between creative, individualized care and institutional policies, whereas families emphasized the shared responsibility in finding appropriate care.
conclusionEthical care for persons experiencing SPMI demands attention to autonomy, collaboration, and resource distribution. Greater accessibility to ethical support systems and tailored approaches are needed to balance recovery-oriented care with a palliative care approach, ensuring dignity and respect for this vulnerable group. CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
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.