THE ETHICAL AND CLINICAL DIMENSIONS OF INTERDISCIPLINARY PATIENT MANAGEMENT: A SYSTEMATIC REVIEW OF THE ROLES OF PATIENT CARE, RADIOLOGY, RADIOTHERAPY, NURSING, AND FORENSIC SCIENCES
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Keywords
clinical ethics, interdisciplinary care, patient management, radiology ethics, radiotherapy ethics, nursing ethics, forensic ethics, systematic review
Abstract
Background: Modern patient management is inherently interdisciplinary, requiring seamless collaboration between diverse clinical and para-clinical fields. This integration, while essential for comprehensive care, presents complex ethical and clinical challenges that are often siloed within individual specialties. A holistic understanding of these dimensions across key domains—direct patient care, radiology, radiotherapy, nursing, and forensic sciences—is lacking. Objective: This systematic review aims to synthesize the existing literature on the primary ethical and clinical challenges encountered in these five domains, identify common themes and unique conflicts, and propose a framework for ethical interdisciplinary collaboration. Methods: A systematic search was conducted following PRISMA guidelines across four electronic databases (PubMed, Scopus, Web of Science, and CINAHL) for articles published between 2013 and 2023. Studies were included if they explicitly discussed ethical dilemmas or clinical management challenges within one or more of the target disciplines. Quality assessment was performed using appropriate critical appraisal tools. Results: Of 2,158 identified records, 78 studies met the inclusion criteria. The synthesis revealed four overarching ethical themes: 1) Autonomy and Informed Consent (e.g., complexities in radiology and radiotherapy regarding risk communication), 2) Justice and Equity (e.g., resource allocation in nursing, access to advanced imaging), 3) Beneficence and Non-Maleficence (e.g., balancing treatment efficacy with toxicity in radiotherapy, dual loyalty in forensic sciences), and 4) Confidentiality and Privacy (e.g., data sharing in digital radiology, sensitive information in nursing notes). Clinically, challenges centered on communication gaps between disciplines, the burden of technological advancement, and moral distress among professionals, particularly nurses and forensic practitioners. Conclusion: The ethical and clinical landscape of interdisciplinary patient management is fraught with challenges that transcend individual specialties. Effective navigation requires moving beyond siloed approaches to develop integrated ethical frameworks. Prioritizing interdisciplinary ethics education, implementing structured communication protocols like SBAR, and establishing ethics committees with diverse representation are critical steps toward ensuring equitable, compassionate, and ethically sound patient care.
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