title: Experiences of ethical issues when caring for children with cancer.
abstract: BACKGROUND
  The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethical issues.
  
  
  OBJECTIVE
  The purpose of this study was to describe healthcare professionals' experiences of ethical issues and ways to deal with these when caring for children with cancer.
  
  
  METHODS
  A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories.
  
  
  RESULTS
  The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics.
  
  
  CONCLUSIONS
  Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care.
  
  
  CONCLUSIONS
  Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents' involvement be "turned around," that is, contribute to a holistic perspective of ethics in cancer care of children?
authors.affiliation: Author Affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Bartholdson
authors.forename: Kim
authors.initials: K
authors.lastname: Lützén
authors.forename: Klas
authors.initials: K
authors.lastname: Blomgren
authors.forename: Pernilla
authors.initials: P
authors.lastname: Pergert
mesh_terms: D000328:Adult; D000067576:Child Health / Q000941:ethics*; D004993:Ethics, Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D009740:Nursing Staff / Q000941:ethics; D011795:Surveys and Questionnaires; D013548:Sweden