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.

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