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.

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

Acknowledgments

The authors would like to thank Genevieve Olivier, PT, and Kevin R. Binning, PhD, for their comments on this article.