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Published on: February 16, 2011
Moral experiences of children with medical complexity: A participatory hermeneutic ethnography in Brazil
Raíssa Passos Dos Santos1, Mary Ellen Macdonald2, Franco A Carnevale3
1Ingram School of Nursing, McGill University, Bourcherville, QC, Canada.
Insights
Children with medical complexity, or chronically ill children with complex needs, express moral experiences by resisting societal norms. They advocate for inclusion in decisions and voice concerns about their future.
Area of Science:
- Pediatric Healthcare
- Medical Ethics
- Sociology of Health
Background:
- Children with medical complexity (CMC) are chronically ill and medically fragile, presenting complex care needs.
- Care for CMC involves significant ethical and moral considerations.
- Existing literature often overlooks the moral agency and lived experiences of CMC.
Purpose of the Study:
- To understand the moral experiences of children with medical complexity (CMC).
- To explore CMC's perspectives as moral agents capable of interpreting their experiences.
- To investigate how sociopolitical contexts shape perceptions of CMC.
Main Methods:
- Participatory hermeneutical ethnographic study.
- Involved eight children with medical complexity and their families.
- Focused on children's views as moral agents.
Main Results:
- CMC express moral experiences through resistance to dominant views of "normal" children.
- Children with medical complexity seek inclusion in decision-making processes.
- CMC articulate concerns regarding painful treatments and future aspirations.
Conclusions:
- Children with medical complexity possess unique moral insights into their lives.
- Understanding CMC's interpretations is crucial in sociopolitical contexts.
- This research informs a more nuanced understanding of children's interests and values.
Abstract:
Children with medical complexity have been defined within the literature as chronically ill and medically fragile children with complex care needs. Care for these children raises significant ethical and moral considerations. Therefore, this participatory ethnographic study conducted with eight children and their families aimed to better understand the moral experiences of children with medical complexity, based on views of children as moral agents and capable of understanding and expressing interpretations about their lived experiences. Through our participatory hermeneutical ethnographic research, we were able to shed light on how children with medical complexity express their moral experiences within a complex sociopolitical context, perpetuating dominant outlooks on what is considered a "normal" child. Children with medical complexity described their resistance to these dominant views as they strive to be included in discussions about matters that affect them, reacting to painful medical procedures and treatments, and expressing their concerns about their future aspirations. The knowledge advanced by this study about moral experiences of children with medical complexity can inform understandings of children's interests based on their own interpretations within complex sociopolitical contexts that value their lives differently.
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