You don’t have to go home but you can’t stay here: The ethics of indefinite pediatric hospitalizations
Friday, October 13, 2023
3:15 PM – 4:30 PM ET
Location: Galena (Fourth Floor)
Adult care models offer options for prolonged hospital-level treatment for the chronically acutely ill, supporting extended, gradual recovery. Few children have access to this care model. Rather, when children have ongoing needs or display physiologic instability that precludes foreseeable hospital discharge, they must remain hospitalized. These hospitalizations can be bolstered by supportive therapies and interprofessional approaches that allow some children to grow, develop, and potentially thrive over the course of months to years, challenging the assumption that prolonged, indefinite hospitalization is incompatible with “living a good life.”
We will examine the ethics of indefinite pediatric hospitalization through multiple lenses, including resource allocation, quality of life, parental authority, child autonomy and lived experience, and probabilistic futility. We will identify empirical and normative gaps that, if filled, might inform systematic decision tools used to define duration limits to ultra-long hospitalizations, determine what level of prognostic certainty is required to deem discharge impossible, and consider whether some prospect of eventual discharge is required to ethically justify indefinite hospitalization.
Erica Andrist – Pediatrics – University of Michigan; Naomi Laventhal – Pediatrics – University of Michigan