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What is the impact of high-profile end-of-life disputes on paediatric intensive care trainees?
  1. Clare Emily Bell1,
  2. Mariana Dittborn2,
  3. Joe Brierley2
  1. 1 Stoke Manderville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
  2. 2 Paediatric Bioethics Centre, Great Ormond Street Hospital For Children NHS Trust, London, UK
  1. Correspondence to Dr Clare Emily Bell, Great Ormond Street Institute of Child Health, University College London Institute of Child Health, London WC1N 1EH, UK; clarebell1{at}nhs.net

Abstract

Introduction This study explores UK paediatric intensive care (PIC) trainees’ thoughts and feelings about high-profile end-of-life cases recently featured in the press and social media and the impact on their career intentions.

Methods Semi-structured interviews were conducted with nine PIC-GRID trainees (April to August 2021). Interview transcripts were analysed using thematic analysis.

Results Six main themes were identified: (1) All participants wished to do what was best for the child, feeling conflicted if this meant disagreeing with parents. (2) Interviewees felt unprepared and expressed deep concern about the effect of high-profile cases on their future career; all had reconsidered their training in PIC due to concerns about future high-profile end-of-life disputes, despite this all were still in training. (3) Specific training on the ethical and legal nuances of such cases is required, alongside targeted communication skills. (4).All cases are unique. (5) All had purposefully minimised their social media presence. (6) Working in a supportive environment is crucial, underscoring the importance of clear and unified team communication.

Conclusion UK PIC trainees feel unprepared and anxious about future high-profile cases. A parallel can be drawn to child protection improvements following significant educational investment after government reports into preventable child abuse deaths. Models for supporting trainees and establishing formal PIC training are required to improve trainees’ confidence and skills in managing high-profile cases. Further research with other professional groups, the families involved and other stakeholders would provide a more rounded picture.

  • child health services
  • ethics
  • intensive care units, paediatric
  • paediatrics

Data availability statement

Data are available upon reasonable request. Deidentified participant interview transcripts, are available from Dr Clare Bell, ORCID identifier 0000-0002-8331-5758 reuse is permitted after discussion with the research team in related research.

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Data availability statement

Data are available upon reasonable request. Deidentified participant interview transcripts, are available from Dr Clare Bell, ORCID identifier 0000-0002-8331-5758 reuse is permitted after discussion with the research team in related research.

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Footnotes

  • Twitter @clarebell99

  • Contributors CEB and JB conceived the presented idea, CEB and JB designed the study, and CEB completed the interviews and coded the data. CEB, JB and MD analysed the data. CEB, JB and MD wrote the manuscript. CEB is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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