ArticleCanadian family physician Medecin de famille canadien1997
Ethical conflicts in home care. Patient autonomy and physician advocacy.
Article in Canadian family physician Medecin de famille canadien, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed, 9 citations in OpenAlex.
- Blurred lines: Ethical challenges related to autonomy in home-based care.Nursing ethics · 2024Article
- Ethical challenges in primary care: a focus group study with general practitioners, nurses and informal caregivers.Family practice · 2019Article
- Home assessment and care.Canadian family physician Medecin de famille canadien · 2000Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify whether and how family physicians practising home care resolve ethical dilemmas in clinical management of homebound patients and to examine whether the self-reported, theoretical ethical positions of these physicians match their actual patient management.
designCross-sectional survey.
settingQuebec community-based home care program.
participantsQuebec family physicians actively involved in community-based home care: 85 men and 65 women.
main outcome measuresPhysician level of agreement with theoretical ethical statements about autonomy, caregiver needs, and resource allocation; management options chosen for a clinical case vignette; and mechanisms used for resolving conflicts.
resultsThere were 209 respondents to the 279 questionnaires sent (75%). Of these, 59 who were not currently involved in home care were excluded, leaving 150 participants. Most (83.3%) physicians surveyed agreed with the ethical principle of patient autonomy; 88.7% agreed that the interests of family caregivers are important in decisions regarding patients, and 72.0% agreed that limiting home care services is reasonable in the context of limited resources. In managing a patient, 65.3% of physicians thought the patient should be placed in a nursing home against her wishes because of "danger to self," while 82.7% felt she should be placed if the caregiver is "exhausted." Three quarters of physicians did not limit or decrease home care services, despite noncompliance.
conclusionsFamily physicians practising community-based home care in Quebec have practical views on various ethical principles guiding home care practice. Except in the area of limiting or discontinuing home care services, their ethical framework is reflected in a case vignette of patient management.
Indexed as
Identifiers
9426933PMC2255107W1513296735What 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.