Abstract
Background: Ethical issues are a common occurrence in healthcare provision. They occur when a choice has to be made whereby the available options are seen as mutually exclusive. This can result in moral distress for healthcare professionals. International literature implies that providing clinical ethics support services to healthcare professionals can reduce moral distress, increase moral competencies and improve the quality of patient care. The main aim of this study was to evaluate whether New Zealand healthcare professionals thought there was enough availability of clinical ethics support. It also tried to find out what type of clinical ethics support services are available in New Zealand, how these were experienced, and finally, what healthcare professionals would like to see in the future as part of clinical ethics support.
Methodology: The study was completed using a quantitative survey. The online survey was distributed to Te Whatu Ora regional hospitals, professional bodies of healthcare practitioners and Māori and Pasifika healthcare providers. The total possible pool of registered healthcare professionals was 151,394. The data was collected from August 2021 to December 2021. The data was analysed using a limited form of statistical analysis. The participants consisted of healthcare professionals aged 18 to 60+. Sixty percent of the participants identified as female. Most participants were from European backgrounds (59%). A small proportion was of Māori descent (4%). The participants represented a variety of health professions (doctors, 31%, allied health professions 28%, nursing, 10%). The survey contained questions about how healthcare professionals recognised and experienced ethical issues, what types of clinical ethics support were available and what they would like to access if more support were accessible.
Results: A total of 121 participants took part in the survey. Only 25% of participants stated that enough clinical ethics support was available. The most reported accessed form of clinical ethics support was through policies and guidelines. Very few participants had access to a dedicated clinical ethics support service like a Clinical Ethics Advisory Group (CEAG) (13%) or a clinical ethics consultant (6%). The majority of the participants indicated that more discussions about the ethical aspects of clinical practice should occur (66%). Half the participants stated they would like access to policies and guidelines (51%). A need for an increase in ethics education was also mentioned (49%), as was having a team member trained in ethics (45%). About a third of participants were interested in a dedicated clinical ethics support service like a clinical ethicist (36%) or a CEAG (34%).
Conclusion: There appears to be limited availability of dedicated clinical ethics support services for New Zealand healthcare professionals. Most participants would like to see an increase in some form of clinical ethics support. As indicated by the participants, the preferred methods of clinical ethics support are policies and guidelines, increased ethics education, and having a team member trained in ethics.