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Identifying ethical challenges in a rehabilitation hospital: initial steps of the first living lab in rehabilitation ethics (LEViER)
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Julien Dery

Identifying ethical challenges in a rehabilitation hospital: initial steps of the first living lab in rehabilitation ethics (LEViER)

Julien Dery1, Camille Desforges2, André Potvin2, Aurélie Garceau2, Desrochers Pascal2, Arthur Filleul3, Tiffany Te4, Zidarov Diana5, Racine Eric3, Anne Hudon3, Matthew Hunt6

1 Université du Québec à Trois-Rivières, Canada

2 Centre Intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Canada

3 University of Montreal, Canada

4 Université McGill, Canada

5 Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Canada

6 McGill University, Canada

Introduction/Rationale: Rehabilitation teams, managers, patients and their families encounter ethical challenges, where values conflict, but these are not often openly tackled with different stakeholders, thereby impending integrative and effective solutions. We report on the initial steps of a first living lab in rehabilitation ethics (LEViER), to engage in creating a collaborative space for identifying and addressing these challenges. 

Objectives:  Identify ethical challenges experienced by the community of a rehabilitation hospital and determine potential cocreative research projects addressing these ethical challenges.

Methods/Approach: Semi-structured interviews or focus groups were conducted with health care managers, patients, health care professionals (including occupational therapists) and a caregiver (n total=37). Interviews were conducted by a researcher and a research coordinator, with the participation of two research patient partners who contributed to developing the interview guide and conducting pilot interviews. Notes were taken during the interviews and analyzed qualitatively using an inductive approach to identify themes. 

Results/Practice Implications:  Ten themes were identified and then presented to an interdisciplinary working group formed to help prioritize them. The group collaboratively developed criteria for prioritizing the ethical themes, including their relevance to all members of the hospital community. Three themes were selected for further exploration and the development of targeted research projects: (1) discharge planning in rehabilitation, (2) communication between health care staff and patients, (3) and waiting times experienced by patients.

Conclusion/Significance to the Occupational Therapy Profession: As occupational therapists are an integral part of the rehabilitation community, they live and witness various ethical challenges. The initials steps of LEViER are setting in motion creative research projects fostering awareness of these challenges and promoting collaborative approaches to addressing them.