Ethical Issues in a Pediatric Post-acute Care Hospital: Implications for Patients, Providers, and Ethicists

Erica Salter and colleagues report the results of a survey of a pediatric post-acute care hospital. They identify the ethical issues the staff encounter most frequently and their assessment of the adequacy of resources to resolve them. As the first study of its kind, it makes a significant contribution to the literature. It highlights the need of addressing the lack of support for children with medical complexity’s caregivers. It raises the possibility that these ethical issues result in employee moral distress, diminished well-being, and increased turnover. It challenges ethicists to improve methods in their field for making comparisons between institutions and evidence-based recommendations for interventions. These and other investigators will hopefully build on this work by conducting multisite studies and eliciting patient and families’ voices. • Support should be provided for caregivers of children with medical complexity. • Inadequately addressed ethical issues may result in providers’ moral distress. • Ethicists need to improve the methods for describing and evaluating their work.