A systematic review of the literature on ethical aspects of transitional care between child- and adult-orientated health services

Autor: Athanasios Maras, Helena Tuomainen, Paramala Santosh, Cathy Street, Fiona McNicholas, Diane Purper Ouakil, Swaran P. Singh, Giulia Signorini, Moli Paul, Priya Tah, Lesley O'Hara
Přispěvatelé: University of Warwick [Coventry], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, King‘s College London, University of Pisa - Università di Pisa, University College Dublin [Dublin] (UCD), Warwick, Jane
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: BMC Medical Ethics
BMC Medical Ethics, BioMed Central, 2018, 19, pp.73. ⟨10.1186/s12910-018-0276-3⟩
BMC Medical Ethics, Vol 19, Iss 1, Pp 1-11 (2018)
ISSN: 1472-6939
DOI: 10.1186/s12910-018-0276-3⟩
Popis: Background Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services (CAMHS). Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. Methods A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Results Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. Conclusions There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. Electronic supplementary material The online version of this article (10.1186/s12910-018-0276-3) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
Externí odkaz: