Ethical issues in the care of patients with stroke: A scoping review
Leino-Kilpi H.; Stolt M.; Rannikko S.; Suhonen R.
Aims and objectives: The aim was to identify and analyse the ethical
issues in the care of patients with stroke (PwS). The goal was to
understand the nature of the existing knowledge on the topic and to
identify whether there are ethical issues specific to the care of PwS.
Background: Stroke is a disease with possible multiple effects on the
patient's overall condition and experienced ethical issues in the care.
Additionally, stroke impacts the life of the significant other. For
health professionals, the care of PwS is challenging at different stages
of the care process. The care of stroke includes several ethically
sensitive situations from the perspectives of all participants. Design:
Scoping review. Methods: The review was conducted following the
five-stage methodological framework of Arksey and O'Malley (2005). The
literature search was conducted in several electronic databases and
complemented with a manual search, resulting in 15 reviewed articles.
The analysis was conducted by charting descriptive numerical data and by
content analysis of the narrative representations. Results: The studies
focused on hospital or rehabilitation contexts and a high number of
studies had a qualitative approach. Three main themes were identifiable:
“decision-making as an ethically challenging act,” “care
process-specific ethical issues” and “environmental ethical issues.”.
Conclusions: Ethical issues occur at different stages of the care
process of PwS and from the viewpoints of all those involved. However,
not all the recognised ethical issues were stroke specific. As the
number of the reviewed articles was limited, more research is needed for
a comprehensive understanding of the topic. Relevance to clinical
practice: Individual health professionals may use the results in
observing their own action from an ethical perspective and to deepen the
ethical understanding of the care of PwS. In health care organisations,
the results may be used in developing the ethical quality of care.
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