Ethical issues related to self-management support of chronic diseases and common mental disorders: A literature review

Introduction: Internationally, self-management support (SMS) is recommended for its benefits by chronic disease management policies. However, ethical issues and risks of harm are present. This study aims to describe the ethical issues surrounding SMS in patients with chronic physical and mental health disorders, and to propose recommendations for SMS practices by primary care nurses in Quebec.

Method: A literature review was conducted in 2021 and updated in 2024 with the concepts of ethical issues and SMS. Fourteen articles were selected, and an inductive thematic analysis was performed. Results: The ethical issues of SMS were grouped into five major themes related to clinical practice: issues related to the conceptualization of SMS, autonomy, responsibility, approach and application of SMS, and inequalities and inequities. Discussion: An ethically responsible practice of SMS is recommended, including training, deployment of an ethical framework, allocation of sufficient resources, assessment of patient needs from the earliest encounters, and establishment of a collaborative and sustainable relationship with patients.