title: Parents' refusal of medical treatment for cultural or religious beliefs: an ethnographic study of health care professionals' experiences.
abstract: Pediatric nurses working in acute care settings serving religious and culturally diverse families may encounter parents whose beliefs influence treatment decisions. Previous literature describes how these complex situations lead to emotional distress and strained relationships between health care provider and family members. An ethnographic study was conducted to investigate the impact of parental treatment refusal on the bedside interactions between pediatric nurses and parents. Twenty in-depth interviews with nurses were conducted, and extensive field notes were taken during data collection. Emotional feelings associated with possible loss of guardianship and subsequent mandated treatment, the impact of the situation on the nurses' health and stress levels, and functional status were all explored. Three themes were identified following interpretive narrative analysis of transcriptions and field notes: weathering the storm of moral conflict, closeness and involvement versus distance and retreat, and battles between the supportive and oppositional groups. The findings of the study lead to a deeper understanding of the complexities of the ethical dilemma surrounding treatment refusal in pediatrics.
authors.affiliation: Dominican University of California, 382 Irwin St., San Rafael, CA 94901, USA. linnard@dominican.edu
authors.forename: Luanne
authors.initials: L
authors.lastname: Linnard-Palmer
authors.forename: Susan
authors.initials: S
authors.lastname: Kools
mesh_terms: D000328:Adult; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology; D002648:Child; D002651:Child Advocacy / Q000941:ethics / Q000523:psychology; D003220:Conflict, Psychological; D018864:Cultural Diversity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D033262:Narration; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000523:psychology*; D033282:Parental Consent / Q000941:ethics / Q000523:psychology; D010290:Parents / Q000193:education / Q000523:psychology*; D010371:Pediatric Nursing / Q000941:ethics; D011368:Professional-Family Relations / Q000941:ethics; D036301:Qualitative Research; D012069:Religion and Psychology; D012495:San Francisco; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000941:ethics / Q000208:ethnology / Q000523:psychology