Ethical Challenges in the Delivery of Family-Centered Nursing Care

PURPOSE: We aimed to explore the ethical challenges encountered by nurses when providing family-centered care. METHODS: Thematic analysis was conducted using data from 82 semi-structured interviews with practicing nurses across four states in the United States. FINDINGS: Theme 1: Navigating professional and ethical boundaries in nursing care that complement or complicate family advocacy; Theme 2: Experiencing family conflicts and disagreements; Theme 3: Feeling helpless at times from ethical, legal, and familial expectations and moral constraints. CONCLUSION: Participants showed commitment to involving families in patient care. Yet, we also observed tension in balancing respect for families' wishes with patient autonomy, which led to moral distress and ethical uncertainty in their professional boundaries. While family-centered care recognizes families' contributions to patient care and health care decisions, ongoing efforts are needed to address the ethical challenges that arise in its implementation in practice.