1. Blurred lines: Ethical challenges related to autonomy in home-based care.
- Author
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Hertzberg CK, Heggestad AKT, and Magelssen M
- Subjects
- Humans, Norway, Female, Male, Middle Aged, Adult, Home Care Services ethics, Home Care Services standards, Personal Autonomy, Qualitative Research
- Abstract
Background: Home-based care workers mainly work alone in the patient's home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges., Aim: The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges., Research Design: The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach., Participants and Research Context: The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants., Ethical Considerations: The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form., Findings: A main challenge was that staff found it difficult to respect the patient's autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff's threshold for considering the use of coercion appeared to be high., Conclusions: Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
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