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Ethical relationships in paediatric emergency medicine: moving beyond the dyad
J Bridges1, R Hanson, M Little
1Department of Economics, Case Western Reserve University, Cleveland, Ohio 44106-7206, United States of America. healtheconomics@hotmail.com
Insights
The traditional doctor-patient model is insufficient for pediatric emergency care. A more complex relationship including parents and other stakeholders is needed for socially beneficial pediatric medical services.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
- Medical Ethics
Background:
- Traditional health services research often focuses on the dyadic doctor-patient relationship.
- In pediatric emergency medicine, parents significantly influence medical service delivery.
- The dyadic model is inadequate for the complexities of pediatric emergency care.
Purpose of the Study:
- To discuss ethical principles in pediatric emergency medicine.
- To evaluate the suitability of the traditional dyadic model in this setting.
- To propose alternative relationship models for improved pediatric care.
Main Methods:
- Cross-disciplinary analysis integrating perspectives from health economics, pediatrics, medical ethics, law, and mental health.
- Review of ethical considerations in pediatric emergency medicine.
- Conceptualization of alternative relationship models.
Main Results:
- A consensus exists that the dyadic doctor-patient model is insufficient for pediatric emergency medicine.
- More complex models, such as triadic, multiple-dyadic, or polyadic relationships, are necessary.
- These models can incorporate parents, family members, medical providers, and community members.
Conclusions:
- Adopting multi-stakeholder relationship models in pediatric emergency settings can enhance the social benefit of medical services.
- Rethinking the traditional dyadic approach is crucial for ethical and effective pediatric emergency care.
- Involving parents and the wider community leads to more socially beneficial healthcare outcomes.
Abstract:
Most areas of health-services research concentrate on a dyadic relationship between doctor and patient. In paediatric emergency medicine it may be necessary to focus on a more complicated relationship because the parents of the child play an important role in the delivery of medical services. This paper discusses the ethical principles in paediatric emergency medicine from the perspective of five disciplines: health economics, paediatrics, medical ethics, law and mental health. The general consensus is that the traditional dyadic model is inadequate and that a more complicated relationship is needed for the paediatric emergency setting, such as triadic, multiple-dyadic or polyadic. Such models allow the inclusion of the parents and possibly other family members, medical providers and community members. If the paediatric setting is considered in such a framework, it may be possible to deliver a more socially beneficial medical service.