Addressing Over-Medicalization in Children with Medical Complexity
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Purpose of Review
Children with medical complexity (CMC) are at risk for over-medicalization and medical child abuse. Their multiple diagnoses, medical complexities, and functional limitations require providers to partner with parents in their care. Even in the context of shared decision-making, over-medicalization and medical child abuse can occur.
We define over-medicalization and medical child abuse as related to the care of CMC, present strategies to prevent, identify, and address shared provider-parent decision-making, and review ethical principles that can guide care decisions.
Complex pediatric care programs designed specifically for CMC promote care of the highest value for CMC through longitudinal documentation of comprehensive assessments and detailed care plans. Goal-directed care—focused on the child’s function and quality of life and the family’s values and preferences—offers opportunities to prevent, identify, and manage over-medicalization and medical child abuse.
KeywordsChildren with medical complexity (CMC) Over-medicalization Medical child abuse (MCA)
Antoinette Laskey, MD  is acknowledged for her contribution to the concept for this paper.
Compliance with Ethical Standards
Conflict of Interest
Colleen Marty, Justin Alvey, Kilby Mann, and Nancy Murphy declare no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
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