title: Access to services for young adults with medical complexity.
abstract: BACKGROUND
  With the number of young people with medical complexity increasing, an increasing number must navigate the transition to adulthood. This transition, in part, involves a situational transition in which young people and their families must access new services in the adult system.
  
  
  OBJECTIVE
  To explore how societal ideologies, communities, and organizations represent the foundation of barriers to access to services.
  
  
  METHODS
  The discussion in this paper, framed within a social justice perspective, outlines barriers to access to services at the societal and community levels including societal ideologies, differences in philosophies of care in pediatric and adult care, physical environments, and availability of services. Ethical Considerations: Since this is an exploratory discussion paper, no ethical approval was required.
  
  
  CONCLUSIONS
  Based on analysis of the literature from a social justice perspective, it is suggested that the adult health care and social service systems do not provide the supports and services necessary to empower young people and their families to achieve their goals and maintain their health and quality of life. It is, thus, an ethical issue that the transfer from pediatric to adult services is occurring in the absence of appropriate services. Recommendations at the individual, community and policy levels highlight how nurses can address this ethical issue to promote more equitable access to services.
authors.affiliation: University of Victoria, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Joly
mesh_terms: D002908:Chronic Disease; D003266:Continuity of Patient Care / Q000592:standards; D006291:Health Policy / Q000639:trends; D006297:Health Services Accessibility / Q000941:ethics* / Q000592:standards*; D006801:Humans; D009656:North America; D012935:Social Justice / Q000592:standards*; D000069341:Transitional Care / Q000331:legislation & jurisprudence / Q000592:standards*; D055815:Young Adult
keywords: Disability; medically fragile; social justice; transition to adulthood; young adults