title: Ethical considerations in transition.
abstract: The objective of this paper is to explore ethical issues in the provision of transitional care. Using five case studies a number of ethical issues in transition and transition care are discussed. These issues include: 1) preserving, promoting and ensuring dignity and respect for patients; 2) fostering and supporting the trusting relationships that young people and their parents have for pediatric providers to their new adult providers by using a graduated system of transfer; 3) recognizing graduated capacity; 4) promoting autonomy and self-management; 5) duties of beneficence and non-maleficence; 6) truthtelling; 7) duty to provide developmentally appropriate care; and 8) duty of pediatric providers to advocate for transitioning patients in the adult system. Attention to the ethical issues surrounding these complex cases has the potential to positively influence a successful transition to adult-oriented health care.
authors.affiliation: Bioethics Program, University Health Network, Toronto, Ontario, Canada. kaufman.hannah@gmail.com
authors.forename: Hannah
authors.initials: H
authors.lastname: Kaufman
authors.forename: Laurie
authors.initials: L
authors.lastname: Horricks
authors.forename: Miriam
authors.initials: M
authors.lastname: Kaufman
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D016497:Adolescent Health Services / Q000941:ethics*; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003266:Continuity of Patient Care / Q000941:ethics*; D005260:Female; D006801:Humans; D008297:Male; D010344:Patient Advocacy; D010372:Pediatrics / Q000941:ethics*; D026684:Personal Autonomy; D012648:Self Care; D035502:Trust; D055815:Young Adult