Table 5.

Atlas.ti^® code groups.

ATLAS.ti Report Bioethical discernment at the End-Of-Life in children with cancer Group of codes Created by Luis Juarez on 12 sep 2021

Clinical determinants at End-Of-Life for Decision-Making 4 Codes:  • Be alive  • Consciousness  • End-Of-Life care quality  • Right to die

Decision-Making Clinical guides 12 Codes:  • 4 steps of principled negotiation  • Advanced care planning, directives  • Boston Children's Hospital policy  • Caring decision handbook  • Children's rights United Nations  • Directives of End-Of-Life care  • Disputed Intervention, Texas Advance Directives Act (TADA)  • Howard's model  • Support material for decision making  • Symbolic interactionism  • Texas Advance Directives Act  • Texas Advance Directives Act, protection to clinicians

Decisions 6 Codes:  • Euthanasia  Comment:   Intentionally terminating life by another person that the person concerned  • Futility  Comment:   The unfortunate situation in which continued therapy will not benefit the  patient and, therefore, ought not be used  • Limitation of therapeutic effort  Comment:   Withdraw of medical treatments to avoid non beneficial support  • Palliative care  Comment:   Palliative care in children, adolescents, and young adults with cancer has led  to better outcomes for patients and their families, improved quality of life, and  relief of suffering  • Palliative sedation  Comment:   The use of sedative medications to relieve intractable and refractory distress  by a reduction in patient consciousness  • Treatment refusal  Comment:   Decision to avoid or not accept recommended elective treatment.

Factors of Patients Decision-Making 6 Codes:  • Adolescent and Young Adult (AYA) group cancer facts  • AYA preferences, values, beliefs  • Children decision making  • Children involvement importance  • Children's preferences  • Patient values

Medical barriers 11 Codes:  • Anxiety of Pediatric Oncologist  • AYA barriers  • Bad news  • Communication skills of Pediatric Oncologist  • Complexity of sharing information  • Confusion in decision  • Discrepancies of treatment  • Obstacles to good care of dying children  • Pediatric oncology security  • Power relationship  • Predictors of attitudes and practices

Medical factors to Decision-Making 63 Codes:  • Anxiety of Pediatric Oncologist  • Beliefs, emotions medics  • Best interest standard  • Biological decisions  • Clinical judgement  • Communication  • Contexting decision  • Decision making  Comment:   A good decision is a logical decision -one based on the uncertainties,  values, and preferences of the decision maker-. A good outcome is one that is  profitable or otherwise highly valued. In short, a good outcome is one that we  wish would happen.The distinction between decision and outcome is still not  clear for most people  • Develop ethical understanding  • Discussion about patient's values, prognosis, options and wishes  • Dishonesty  • Ethical deliberation  • Ethical issues  • Ethical training  • Factors influence medical decision End-Of-Life  • Failure feelings of Pediatric Oncologist  • Free choice principle  • health care providers knowledge  • Honesty  Comment:   Attribute of disclose accurately the extent of knowledge and ignorance  • Hospice service  • Howard's model  • Hubris absent  • Human dignity  • Interview structure to decision-making  • Legality  • Mature minor doctrine  • Medical attitudes at End-Of-Life  • Medical belief  • Medical decision-making capacity  • Medical deontology  • Medical experience  • Medical perception  • Medical preconceptions  • Medical satisfaction  • Medical values  • Medical-legally discussion  • Medical-patient relationship  • Moment to give bad news  • Moment to give support material  • Moral principles  • Multidisciplinary consultation  • Non-ethical standard  • Oncologist time of experience  • Paternalism  • Philosophical aspects of End-Of-Life  • Predictors of attitudes and practices  • Prognostic decision  • Prolonged physiologic life  • Quality of information  • Recognizing individualism  • Sanctity of life  • Satisfaction of Pediatric Oncologist about End-Of-Life care  • Shared decision-making, age  • Shared decision making (SDM)  • Skills to manage symptoms  • Social reality, medical decision  • Training in palliative care  • Understanding of decision  • Unrealistic expectation  • Who makes decisions  • Withhold, withdraw life support  • Work's place of Pediatric Oncologist  • Wrong decision

Parents, patients’ factors for Decision-Making 26 Codes:  • Beliefs, emotions parents  • Cultural relation with decision making  • Culture, decision making  • Death, place, and time  • Decision making involvement  • Decisional quality  • Disagreement patient-parent  • Discussion with shared language  • Empower parents  • Ethics of families  • Ethnic influences on decisions  • Family decision making  • Family influences about End-Of-Life decision  • Health professionals behavioral  • Information comprehension• Institution confidence  • Interview structure to decision-making• Language  • Outcome of shared decision-making  • Parental values  • Shared decision-making, age  • Shared decision-making (SDM)  • Understanding of decision  • Unrealistic expectation of cure  • Who makes decisions  • Withhold, withdraw life support

Principles 4 Codes:  • Beneficence  Comment:   The act of contribution to the welfare of person or humanity  • Justice  Comment:   Appropriate fair, equitable treatment in light of what is due or owed to persons  • Non maleficence  Comment:   The obligation not to inflict harm on others  • Respect for autonomy  Comment:   Individual decision making in health care, self-rule free from controlled interference

Virtues 7 Codes:  • Compassion  Comment:   The disposition to comprehend, assess and weigh the uniqueness of patient´s predicament of illness  • Empathy  • Honesty  Comment:   Attribute of disclose accurately the extent of knowledge and ignorance  • Integrity  Comment:   The person can integrate all the virtues into a whole and can prudentially  judge to reach a decision to act  • Phronesis  Comment:   The capacity of moral insight, the capacity to discern what moral choice or  course of action is most conducive to the good  • Responsibility  • Veracity  Comment:   The capacity of tell the whole truth

Codes without group 6 Codes:  • Advance directive  • Clinical trials participation  • Duration, cost of medical futile  • Futile mediation  • Futility definition  • Futility, treatment goals

Report of all the groups of codes created to analyze the articles included. Every color is associated with each group of codes to facilitate the analysis of corresponding network.