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Moral Distress and Pediatric Palliative Care
Sunny Jeong1, Angela Knackstedt1,2, Jennifer S Linebarger3
1Bioethics Center, Children's Mercy-Kansas City, Kansas City, MO 64108, USA.
Insights
Pediatric palliative care teams can help reduce moral distress in healthcare professionals by improving communication and ethical guidance. Their involvement supports clinicians, patients, and families in challenging pediatric healthcare situations.
Area of Science:
- Pediatric Healthcare
- Medical Ethics
- Palliative Care
Background:
- Moral distress arises from conflicts between personal values and actions in healthcare.
- Pediatric settings present unique challenges due to complex patient-family-clinician dynamics.
- Healthcare professionals experience moral distress, impacting well-being and care delivery.
Purpose of the Study:
- To explore the role of pediatric palliative care (PPC) in mitigating moral distress among healthcare professionals.
- To examine how PPC teams can support clinicians, patients, and families in challenging ethical situations.
- To highlight the benefits of integrating PPC for managing moral distress in pediatric care.
Main Methods:
- Qualitative analysis of experiences within a quaternary pediatric hospital.
- Observational insights into the integration of PPC teams.
- Case study approach focusing on challenging ethical scenarios.
Main Results:
- PPC team involvement reframes challenging situations and enhances communication.
- PPC provides guidance to care teams, patients, and families.
- PPC teams educate multidisciplinary members on respecting diverse values and ethical considerations.
Conclusions:
- Proactive integration of PPC teams is effective in reducing moral distress in pediatric healthcare.
- PPC enhances ethical decision-making and supports diverse patient and family values.
- PPC teams are valuable resources for managing moral distress and improving care quality.
Abstract:
Moral distress is a complex phenomenon whereby a person feels tension, constraint, or conflict with an action or circumstance because it goes against their individual or the perceived collective (e.g., community, organizational, or professional association's) moral stance. In pediatric healthcare settings, managing and mitigating feelings of moral distress can be particularly difficult to navigate through because of the intricate dynamics between the pediatric patient, parent and/or legal guardians, and clinicians. The proactive integration of an experienced pediatric palliative care (PPC) team can be an appropriate step toward reducing clinicians feeling overwhelmed by various case-specific and team management issues that contribute to the development of moral distress among healthcare professionals. Based on our experiences in a free-standing, quaternary pediatric hospital, the involvement of PPC can help reframe the approach to challenging situations, enhance communication, and provide guidance to the care team, patients, and families. Moreover, PPC teams can benefit other multidisciplinary team members through education on respecting the plurality of values of diverse families and patients and consideration of ethical implications during morally challenging situations.
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