What is known about the role of clinical ethics services in cancer care? A systematic/narrative literature review.

ABSTRACT

The use of clinical ethics services (CES) has been increasing over time, but little is known about the role of CES in cancer care. Cancer diagnosis and treatment are emotionally charged and life-changing experiences, raising existential and ethical questions about the quality and meaning of, living and dying. This narrative review seeks to consolidate the available information regarding how CES are accessed and used in cancer care. The review attempts to answer the question, 'What is known about the role of CES in cancer care?' Papers included in this review were identified through searching PubMed and MEDLINE Ovid; a variety of keywords were used to ensure the capture of all relevant literature. 387 papers were identified using the search strategy, 13 papers were included in the final synthesis following the application of the inclusion and exclusion criteria. Citation searching was conducted. 11 of 13 papers were conducted in the USA, 1 in Germany and 1 in South Korea. A variety of study designs were incorporated into this review. Five key roles of CES in cancer care were identified; conflict resolution/mediation, delivery of ethics education to clinical staff, advising on specific aspects of care, guideline development/resource allocation and emotional support of clinicians. This narrative review outlines how CES can assist clinicians to reflect on, better understand and address, the complex ethical dimensions of their practice. The identified literature demonstrates that early involvement of CES may reduce conflict. More research is needed gathering information from CES directly.