In-patient nursing, palliative and hospice care in the time of COVID-19: Social, ethical and legal implications from an intersectional perspective

social sciences - Challenges of SARS-CoV-2 are particularly pronounced in nursing care, even more so for palliative and hospice care, because patients in these settings are particularly susceptible for severe course of COVID-19 and measures necessary to decrease the spread of the virus hamper the very act of caregiving, creating legal, social and ethical dilemmas. These need to be addressed by diversity-sensitive concepts/policies. In the past weeks, providers of nursing, palliative and hospice care by necessity did develop approaches to adjust to a different reality. This study aims to examine these strategies, their perception by patients/relatives and to identify good practice approaches. Based on the findings and using a 6-step process of ethical decision-making, a handbook conceptualizing the determinants of good practice and providing recommendations on how challenges can be addressed will be developed. A mixed-method design is used. It comprises a scoping review of existing guidelines for nursing/palliative/hospice care (A), a document analysis of providers' websites (B), qualitative telephone/video interviews with patients and their relatives (n=10-12) (C), an online survey of in-patient nursing, palliative and hospice facilities in Germany (N=15.677+653) (D), and 8-10 focus group discussions with staff of selected facilities (n=5-7 per group= 40-70) (E). The triangulated findings will be discussed in a discussion circle with patients/relatives and experts in the field of ethics and law (F1) (n=8-10). Guidelines developed will be consented in a second discussion circle (F2).