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[Ethics in pediatric emergencies: Care access, communication, and confidentiality]
J Benoit1, L Berdah1, A Carlier-Gonod1
1Groupe symposium d'Automne 2014 du DES de pédiatrie d'Île-de-France, France.
Insights
Pediatric emergencies require effective communication and child-centered care to ensure therapeutic alliances and protect medical confidentiality. Involving parents and listening to the child are crucial for vulnerable foreign children.
Area of Science:
- Pediatrics
- Medical Ethics
- Child Protection
Background:
- Children face increasing societal precariousness, impacting healthcare access.
- Foreign children in France are subject to specific legislation unfamiliar to caregivers.
- Pediatric emergency settings present communication challenges and risks of abuse.
Purpose of the Study:
- To highlight communication barriers in pediatric emergencies.
- To emphasize the importance of child-centered communication and parental involvement.
- To examine challenges to medical confidentiality in pediatric emergency care.
Main Methods:
- Review of existing legislation and healthcare structures in France.
- Analysis of communication dynamics within pediatric emergency departments.
- Discussion of ethical considerations regarding child participation and confidentiality.
Main Results:
- Pediatric emergency environments can hinder effective communication.
- The child's voice is often overlooked in emergency care dialogues.
- Medical confidentiality faces limitations due to evolving practices and multiple actors.
Conclusions:
- Prioritizing communication and the child's perspective is essential for therapeutic alliances.
- Caregivers need better awareness of legislation supporting foreign children.
- Safeguarding medical confidentiality requires addressing systemic limitations in pediatric emergencies.
Abstract:
Children suffer most from today's increasing precariousness. In France, access to care is available for all children through various structures and existing measures. The support for foreign children is overseen by specific legislation often unfamiliar to caregivers. Pediatric emergencies, their location, organization, actors, and patient flow are a particular environment that is not always suitable to communication and may lead to situations of abuse. Communication should not be forgotten because of the urgency of the situation. The place of the child in the dialogue is often forgotten. Considering the triangular relationship, listening to the child and involving the parents in care are the basis for a good therapeutic alliance. Privacy and medical confidentiality in pediatric emergencies are governed by law. However, changes in treatments and medical practices along with the variety of actors involved imply both individual and collective limitations, to the detriment of medical confidentiality.
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