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Review
What is known about the role of clinical ethics services in cancer care? A systematic/narrative literature review
  1. Jacob Stevenson1,
  2. Alexandra Clinch2,3,
  3. Maria Ftanou2,4 and
  4. Clare Delany2,5
  1. 1 The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
  2. 2 Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. 3 The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
  5. 5 The University of Melbourne Department of Medical Education, Melbourne, Victoria, Australia
  1. Correspondence to Dr Jacob Stevenson; Jacobdeanstevenson{at}gmail.com

Abstract

The use of clinical ethics services (CES) has been increasing over time, but little is known about the role of CES in cancer care. Cancer diagnosis and treatment are emotionally charged and life-changing experiences, raising existential and ethical questions about the quality and meaning of, living and dying. This narrative review seeks to consolidate the available information regarding how CES are accessed and used in cancer care. The review attempts to answer the question, ‘What is known about the role of CES in cancer care?’ Papers included in this review were identified through searching PubMed and MEDLINE Ovid; a variety of keywords were used to ensure the capture of all relevant literature. 387 papers were identified using the search strategy, 13 papers were included in the final synthesis following the application of the inclusion and exclusion criteria. Citation searching was conducted. 11 of 13 papers were conducted in the USA, 1 in Germany and 1 in South Korea. A variety of study designs were incorporated into this review. Five key roles of CES in cancer care were identified; conflict resolution/mediation, delivery of ethics education to clinical staff, advising on specific aspects of care, guideline development/resource allocation and emotional support of clinicians. This narrative review outlines how CES can assist clinicians to reflect on, better understand and address, the complex ethical dimensions of their practice. The identified literature demonstrates that early involvement of CES may reduce conflict. More research is needed gathering information from CES directly.

  • Ethics
  • Cancer
  • End of life care

https://doi.org/10.1136/spcare-2023-004300

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    Footnotes

    • Contributors CD was responsible for study conception and is the study guarantor. JS was responsible for study design, literature search, collection of results and manuscript drafting. JS, AC, MF and CD reviewed manuscripts for inclusion in the study. AC, MF and CD reviewed and made critical revisions to the paper. CD supervised the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.