title: Difficult Discharge in Pediatric Rehabilitation Medicine Causing Moral Distress.
abstract: An ethical dimension exists in nearly all decisions made. Yet, there are clinical decisions in which the ethical dilemma is so difficult for the clinician that it results in moral distress. We present one example of a morally distressing situation in which care was provided for a child who had altered physical abilities after a trauma and was being discharged to a suboptimal family environment. Caring for a child with an acquired spinal cord injury requires significant resources. When a family is able to physically care for the child, but has demonstrated incomplete follow-through, the team is at risk for experiencing significant moral distress.
authors.affiliation: a Pediatric Rehabilitation Medicine , University of Utah/Primary Children's Hospital , Salt Lake City , Utah , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Green
authors.affiliation: b Bioethics Center , Children's Mercy Hospital and Clinics , Kansas City , Missouri , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Carter
authors.affiliation: c Pediatric Rheumatology , Legacy Emanuel-Randall Children's Hospital , Portland , Oregon , USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lasky
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D019988:Children with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010351:Patient Discharge; D013119:Spinal Cord Injuries / Q000534:rehabilitation; D013315:Stress, Psychological / Q000523:psychology*
keywords: Difficult discharge; difficult discharge pediatric rehabilitation; difficult discharge spinal cord injury; ethics and rehabilitation; moral distress; pediatric ethical issues; pediatric spinal cord injury; spinal cord injury