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Dublin Core
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Title
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October 2022 List
Text
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Citation List Month
October 2022 List
URL Address
<a href="http://doi.org/10.1542/peds.2021-055558">http://doi.org/10.1542/peds.2021-055558</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Disposition Decisions in Cases of Medical Complexity and Health Inequity
Publisher
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Pediatrics
Date
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2022
Subject
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Adult; Covid-19; Child; Ethics; Clinical; Health; Inequities; Humans; Palliative Care; Pandemics
Creator
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Shapiro J P; Anspacher M; Madrigal V; Lantos JD
Description
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The question of optimal disposition for children with complex medical and social circumstances has long challenged the well-intentioned clinician. The coronavirus disease 2019 pandemic created unique difficulties for patients, families, and health care providers, in addition to highlighting long-standing racial and socioeconomic inequities in health care. In pediatric hospitals, necessary public health measures such as visitor restrictions shifted many shared decision-making processes such as discharge planning from complicated to impossible. Here, we present the case of a medically complex adult (with a long-standing pediatric condition) whose surrogate decision-maker objected to discharge to a long-term care facility because of restrictions and risks associated with the coronavirus disease 2019 pandemic. We offer the commentary of experts in clinical ethics, intensive care, inpatient subacute care, and palliative care. Our discussion includes analysis of the ethical considerations involved in the case, concrete guidance on steps toward an ethically permissible discharge, and suggestions for how a health equity lens can improve communication and decision-making for families who are victims of systemic racism and economic discrimination.
Identifier
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<a href="http://doi.org/10.1542/peds.2021-055558">10.1542/peds.2021-055558</a>
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2022
Adult
Anspacher M
Child
Clinical
COVID-19
Ethics
Health
Humans
Inequities
Lantos JD
Madrigal V
October 2022 List
Palliative Care
Pandemics
Pediatrics
Shapiro J P