In this Ethics Rounds we present a conflict regarding discharge planning for a febrile infant in the emergency department. The physician believes discharge would be unsafe and would constitute a discharge against medical advice. The child’s mother believes her son has been through an already extensive and painful evaluation and would prefer to monitor her well-appearing son closely at home with a safety plan and a next-day outpatient visit. Commentators assess this case from the perspective of best interest, harm-benefit, conflict management, and nondiscriminatory care principles and prioritize a high-quality informed consent process. They characterize the formalization of discharge against medical advice as problematic. Pediatricians, a pediatric resident, ethicists, an attorney, and mediator provide a range of perspectives to inform ethically justifiable options and conflict resolution practices.
Pediatric Discharge From the Emergency Department Against Medical Advice
FINANCIAL DISCLOSURES: The authors have indicated they have no financial relationships relevant to this article to disclose.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
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Meaghann S. Weaver, Haavi Morreim, Lydia H. Pecker, Rachel O. Alade, David J. Alfandre; Pediatric Discharge From the Emergency Department Against Medical Advice. Pediatrics January 2022; 149 (1): e2021050996. 10.1542/peds.2021-050996
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