title: Ethical challenges in home mechanical ventilation: a secondary analysis.
abstract: The aim of this study was to explore the ethical challenges in home mechanical ventilation based on a secondary analysis of qualitative empirical data. The data included perceptions of healthcare professionals in hospitals and community health services and family members of children and adults using home mechanical ventilation. The findings show that a number of ethical challenges, or dilemmas, arise at all levels in the course of treatment: deciding who should be offered home mechanical ventilation, respect for patient and family wishes, quality of life, dignity and equal access to home mechanical ventilation. Other challenges were the impacts home mechanical ventilation had on the patient, the family, the healthcare services and the allocation of resources. A better and broader understanding of these issues is crucial in order to improve the quality of care for both patient and family and assist healthcare professionals involved in home mechanical ventilation to make decisions for the good of the patient and his or her family.
authors.affiliation: Department of Anesthesiology, Nordland Hospital, Bodoe, Norway. kdybwik@gmail.com
authors.forename: Knut
authors.initials: K
authors.lastname: Dybwik
authors.forename: Erik Waage
authors.initials: EW
authors.lastname: Nielsen
authors.forename: Berit Støre
authors.initials: BS
authors.lastname: Brinchmann
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D026686:Beneficence; D017028:Caregivers / Q000523:psychology; D002648:Child; D002908:Chronic Disease / Q000628:therapy; D003153:Community Health Services; D017144:Focus Groups; D006297:Health Services Accessibility / Q000592:standards; D018575:Home Care Services, Hospital-Based / Q000941:ethics*; D006801:Humans; D007407:Interviews as Topic; D009664:Norway; D028701:Patient Rights; D026684:Personal Autonomy; D017410:Practice Guidelines as Topic / Q000592:standards; D017009:Professional Autonomy; D036301:Qualitative Research; D011788:Quality of Life; D012121:Respiration, Artificial / Q000941:ethics*