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- W4254182368 abstract "Imagine you are a clinician and you have just finished a ward round involving a complex paediatric patient. It is a Thursday afternoon. Watching the television later, you discover the whole case—including your name and personal details—is the lead item on the evening news. Within another 24 h, not only is the issue a matter of international debate, but US President Trump and the Pope are also embroiled in the case. Decisions about care in critical illness patients and end-of-life situations—as in the cases of Charlie Gard and Alfie Evans—along with communication failure are important sources of dispute. Welcomed advice from the UK Royal College of Paediatrics and Child Health (RCPCH), published on April 18, sensibly recommends a clinician be assigned a lead role to liaise between family and staff. Clinicians need to recognise and acknowledge a family's understanding of the underlying disease, and be responsible for the overall care of the child. The advice urges health-care professionals to avoid giving parents unrealistic expectations. Palliative care teams should be involved early, psychosocial support should be offered, and external expert advice—including ethical and legal support—should be sought if necessary. Importantly, the report recommends families should be helped to understand the possible effects on their personal lives if they involve the press and social media. The RCPCH is to be congratulated on this new advice, not least because a rising prevalence of difficult to manage and life-threatening conditions in children and adolescents and an increasing availability of advanced forms of life-supporting systems are likely to lead to more cases ending in conflict. A proliferation of online information about innovative, often unproven, treatments, online fundraising, and a growing willingness to use social media to air grievances against health-care staff mean that such disputes and conflicts will forever be part of the clinical landscape. However, this comprehensive guidance—specifically developed for paediatric practice—have at least provided useful advice for health-care professionals facing potential conflict in the clinic or ward." @default.
- W4254182368 created "2022-05-12" @default.
- W4254182368 creator A5085953656 @default.
- W4254182368 date "2019-04-01" @default.
- W4254182368 modified "2023-09-25" @default.
- W4254182368 title "Paediatric practice in a modern era" @default.
- W4254182368 doi "https://doi.org/10.1016/s0140-6736(19)30904-3" @default.
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