scholarly journals Clinic, courtroom or (specialist) committee: in the best interests of the critically Ill child?

2018 ◽  
Vol 44 (7) ◽  
pp. 471-475 ◽  
Author(s):  
Richard Huxtable
Keyword(s):  
Critically Ill ◽  
Support Services ◽  
Best Interests ◽  
Ethics Support ◽  
Specialist Services ◽  
Critically Ill Child ◽  
The Uk ◽  
Promising Development ◽  
Specialist Committee

Law’s processes are likely always to be needed when particularly intractable conflicts arise in relation to the care of a critically ill child like Charlie Gard. Recourse to law has its merits, but it also imposes costs, and the courts’ decisions about the best interests of such children appear to suffer from uncertainty, unpredictability and insufficiency. The insufficiency arises from the courts’ apparent reluctance to enter into the ethical dimensions of such cases. Presuming that such reflection is warranted, this article explores alternatives to the courts, and in particular the merits of specialist ethics support services, which appear to be on the rise in the UK. Such specialist services show promise, as they are less formal and adversarial than the courts and they appear capable of offering expert ethical advice. However, further research is needed into such services – and into generalist ethics support services – in order to gauge whether this is indeed a promising development.

Local Authority and Voluntary Adoption Agencies' Arrangements for Supporting Adoptive Families: A Survey of UK Practice

2003 ◽  
Vol 27 (3) ◽  
pp. 51-60 ◽  
Author(s):  
Alan Rushton
Keyword(s):  
Support Services ◽  
Service Provision ◽  
Local Authority ◽  
Adoptive Families ◽  
Looked After Children ◽  
Specialist Services ◽  
Timely Access ◽  
Adoption Agencies ◽  
The Uk ◽  
Voluntary Adoption

This paper presents the main messages from a survey of adoption support services in local authority and voluntary adoption agencies throughout the UK. The survey examined developments in service provision and delivery resulting from the Government's drive to increase the use of adoption as an option to secure permanence for looked after children. Alan Rushton reports that substantial changes are taking place in many agencies, but that there is further to go to achieve equitable and timely access to specialist services when they are needed.

scholarly journals Medical Tourism and the Best Interests of the Critically ill Child in the Era of Healthcare Globalisation

2020 ◽  
Vol 28 (4) ◽  
pp. 696-730
Author(s):  
Neera Bhatia ◽  
Giles Birchley
Keyword(s):  
Critically Ill ◽  
Healthcare Professionals ◽  
Medical Tourism ◽  
Case Law ◽  
Best Interests ◽  
Critically Ill Children ◽  
Medical Law ◽  
Novel Treatments ◽  
Critically Ill Child ◽  
The Law

Abstract In this article, we examine emerging challenges to medical law arising from healthcare globalisation concerning disputes between parents and healthcare professionals in the care and treatment of critically ill children. We explore a series of issues emerging in English case law concerning children’s medical treatment that are signs of increasing globalisation. We argue that these interrelated issues present distinct challenges to healthcare economics, clinical practice, and the operation of the law. First, social media leverages the emotive aspects of cases; secondly, the Internet provides unfiltered information about novel treatments and access to crowdfunding to pay for them. Finally, the removal of barriers to global trade and travel allows child medical tourism to emerge as the nexus of these issues. These aspects of globalisation have implications for medicine and the law, yet child medical tourism has been little examined. We argue that it affects a range of interests, including children’s rights, parents’ rights as consumers, and the interests of society in communalised healthcare. Identifying putative solutions and a research agenda around these issues is important. While cases involving critically ill children are complex and emotionally fraught, the interconnectedness of these issues requires the law to engage and respond coherently to the impacts of healthcare globalisation.

Looking after critically ill children

2019 ◽  
pp. 645-651
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Child Abuse ◽  
Critically Ill ◽  
Medical Practitioner ◽  
Self Report ◽  
Critically Ill Children ◽  
Vulnerable Children ◽  
Injured Child ◽  
Number Of Children ◽  
Critically Ill Child ◽  
The Uk

This chapter discusses paediatrics in critical care and includes discussion on both paediatric transfers for the adult intensivist and looking after a vulnerable child (safeguarding children for the adult practitioner). With the centralization of specialist services into a limited number of hospitals across the UK, an increasing number of children require an interhospital transfer. These include but are not limited to the transfer of the critically ill child. Between 2012 and 2014, 18 500 transfers of critically ill or injured children were undertaken across the UK, of which 2400 were undertaken by non-specialist teams. These patients are some of the sickest children. It is while in transit that these patients are most at risk and the transferring team is most exposed. To minimize risks it is important that the team holds the relevant skills to stabilize and transfer children. A systematic approach is vital. The patient’s condition should be optimized before transfer and any likely difficulties anticipated and a plan to tackle any complications swiftly and effectively is agreed prior to the transfer. In this chapter we offer our approach to the safe transfer of the critically ill child. The second part of this chapter offers an introduction into the safeguarding of vulnerable children. A 2009 survey conducted by the National Society for the Prevention of Cruelty to Children asking children to self-report abuse and neglect found that 18.6% of 11–17-year-olds said they had experienced some type of severe maltreatment. The high prevalence of child abuse makes it likely for the medical practitioner who is mostly caring for adult patients to encounter vulnerable children in clinical practice. This will often happen when participating in the resuscitation of a critically ill or injured child, when anaesthetizing a child, or when looking after a caregiver of such a child. The aim of this chapter is to provide these practitioners with the information that will help them to identify possible child abuse and make them aware of their responsibilities towards these children and their options for action.

scholarly journals Clinical ethics support services during the COVID-19 pandemic in the UK: a cross-sectional survey

2021 ◽  
pp. medethics-2021-107818
Author(s):  
Mariana Dittborn ◽  
Emma Cave ◽  
David Archard
Keyword(s):  
Support Services ◽  
Clinical Ethics ◽  
Research Team ◽  
Moral Distress ◽  
Clinical Staff ◽  
Cross Sectional ◽  
Clinical Ethics Support ◽  
Ethics Support ◽  
Advisory Boards ◽  
The Uk

BackgroundThe COVID-19 pandemic highlighted the need for clinical ethics support provision to ensure as far as possible fair decision making and to address healthcare workers’ moral distress.PurposeTo describe the availability, characteristics and role of clinical ethics support services (CESSs) in the UK during the COVID-19 pandemic.MethodA descriptive cross-sectional online survey was developed by the research team. The survey included questions on CESSs characteristics (model, types of support, guidance development, membership, parent and patient involvement) and changes in response to the pandemic. Invitations to participate were widely circulated via National Health Service institutional emails and relevant clinical ethics groups known to the research team.ResultsBetween October 2020 and June 2021, a total of 53 responses were received. In response to the pandemic, new CESSs were established, and existing provision changed. Most took the form of clinical ethics committees, groups and advisory boards, which varied in size and membership and the body of clinicians and patient populations they served. Some services provided moral distress support and educational provision for clinical staff. During the pandemic, services became more responsive to clinicians’ requests for ethics support and advice. More than half of respondents developed local guidance and around three quarters formed links with regional or other local services. Patient and/or family members’ involvement in ethics discussions is infrequent.ConclusionsThe pandemic has resulted in an expansion in the number of CESSs. Though some may disband as the pandemic eases, the reliance on CESSs during the pandemic demonstrates the need for additional research to better understand the effectiveness of their various forms, connections, guidance, services and modes of working and for better support to enhance consistency, transparency, communication with patients and availability to clinical staff.

Care of the critically ill child in Irish hospitals

2015 ◽  
Author(s):  
Dr G Maloney ◽  
◽  
Dr M J White ◽  
Dr K Bailey ◽  
Dr A Bergin ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Child
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