Rebecca Propper, MD
Assistant Professor
University of Chicago, United States
Disclosure information not submitted.
David Schlundt, PhD
Associate Professor of Psychology
Vanderbilt University, United States
Disclosure information not submitted.
Kemberlee Bonnet, MA
Coordinator, Qualitative Research Core
Vanderbilt University, United States
Disclosure information not submitted.
Jessica Turnbull, MD, MA
Assistant Professor
Monroe Carell Jr Childrens Hospital at Vanderbilt University Medical Center, United States
Disclosure information not submitted.
Title: National Survey of Ethical Dilemmas in Pediatric Critical Care
Introduction: The practice of pediatric critical medicine is ethically complex, with high risk/high reward decision-making, inherent uncertainty, and multiple stakeholders. There is limited understanding of what the most common ethical dilemmas are and how pediatric intensivists navigate these dilemmas.
Methods: The study was IRB approved. We conducted semi-structured group interviews in which participants reflected on common ethical dilemmas. Group interviews were recorded, transcribed and independently coded. From these data, we created a case-based ten-question survey with multiple choice answer options along with a free text option. The survey was disseminated nationally along with questions to assess participants’ demographics. Using a mix-methods approach allowed us to understand the nuances of the participants’ responses, quantitatively analyze the relative frequencies of various themes, and use the most common themes to develop our national survey.
Results: 88% (15/17) of eligible physicians participated in the focus groups. Responses were coded into four categories, with multiple subcategories. The national survey derived from the focus groups was sent to approximately 1199 distinct emails, and 299 partial and complete replies were received (approximately 32% response rate after accounting for bounce-back emails). Respondents generated over 750 free response answers, which were also coded using a new coding system.
Conclusions: Results from the survey found respondents expressed divergent positions. Some chose to use the free responses to share personal experiences that informed their responses to the dilemma. The study identified the need for continued space to discuss these issues.