Exploration des dilemmes éthiques entourant le traitement de la dysphagie à l’enfance et leurs solutions : perceptions d’intervenants

Abstract

A review of the literature reveals that there is little knowledge about the ethical dilemmas (and their solutions) surrounding the treatment of childhood dysphagia. The aim of this study is to explore and describe the ethical dilemmas faced by practitioners in the treatment of feeding problems in children with dysphagia and the ways in which these problems are solved. Semi-directed interviews were conducted with eight health practitioners working in an integrated university health and social services centre (CIUSSS) in Quebec. All the practitioners mentioned that they had encountered ethical dilemmas, on average twice a year, and these had caused them some distress. These dilemmas have three main causes: refusal of treatment by some parents, partial follow-up of professional recommendations and differences of opinion with external partners. To resolve these dilemmas, practitioners say they rely on team discussions and the help of superiors, external partners or parents. The majority of participants mentioned that they needed additional means to resolve these dilemmas and proposed some avenues in that direction. The results of the research generally correspond to those documented in the literature. More attention should be paid to these dilemmas, given the scarcity of ethical resources currently available, that are adapted to and able to address these situations, and the distress that these cause.

Keywords

• ethics
• dilemma
• distress
• dysphagia
• childhood
• perception
• intervener
• phenomenology