Related Experiment Videos

Moral distress in pediatric palliative care: a case study

Scott M Klein1

  • 1Clinical Services and Pediatric Critical Care Medicine, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, New York 11219, USA. sklein@maimonidesmed.org

Journal of Pain and Symptom Management
|July 21, 2009
PubMed

Insights

Disagreements in pediatric end-of-life care can cause moral distress for healthcare providers. Ethics teams and palliative care consultations can help mediate these conflicts and support families and staff.

Area of Science:

  • Pediatric Palliative Care
  • Bioethics
  • Medical Ethics

Background:

  • End-of-life decisions in pediatric care are frequently complicated by discord between families and healthcare teams.
  • Such conflicts can precipitate moral distress among healthcare providers.
  • Prognostic uncertainty further exacerbates these challenging situations.

Purpose of the Study:

  • To analyze the ethical and legal implications of conflicts arising during end-of-life care discussions for children with severe, life-limiting conditions.
  • To explore strategies for managing healthcare team distress and supporting effective palliative care.

Main Methods:

  • Case study analysis of a child with a severe life-limiting syndrome.
  • Ethical and legal implications were examined in the context of parental and healthcare team conflict.

Main Results:

  • Conflicts between families and healthcare teams regarding pediatric end-of-life decisions are common and distressing.
  • Ethics teams can offer crucial guidance and mediation in goals of care discussions.
  • Palliative care consultations provide essential support for both parents and children.

Conclusions:

  • Addressing healthcare provider distress is vital for delivering effective pediatric palliative care.
  • Ethics committees and palliative care services are essential resources for navigating complex end-of-life care scenarios.
  • Mediation and support are key to resolving conflicts and ensuring patient-centered care.

Related Concept Videos

Ethical Dilemmas I01:17

Ethical Dilemmas I

Ethical dilemmas in nursing are of utmost importance, as they often arise from the tension between adhering to core ethical principles and the practical realities of healthcare delivery. These dilemmas require nurses to navigate complex situations where competing ethical considerations pull them in different directions.
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...
Ethical Issues01:27

Ethical Issues

Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Dilemmas II01:30

Ethical Dilemmas II

Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
Nursing Ethical Principles II01:27

Nursing Ethical Principles II

Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
Ethics and Bioethics01:22

Ethics and Bioethics

Ethics is a philosophical study of moral actions. Ethics attempts to determine what is valuable for individuals and society. It examines the rational justification of moral judgments and analyzes what is morally just, fair, and right. Bioethics is a sub-discipline of applied ethics that analyzes the philosophical, social, and legal issues in life sciences and medicine. Ethical theories serve as a foundation for decision-making and represent the viewpoints from which people seek direction. They...
Continuing Care01:25

Continuing Care

Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...