Journal article
As Low As Reasonably Practicable (ALARP), a moral model for clinical risk management in the setting of technology dependence
- Abstract:
- Children dependent upon life-prolonging medical technology are often subject to a constant background risk of sudden death or catastrophic complications. Such children can be cared for in hospital, in an intensive care environment with highly trained nurses and doctors able to deliver specialised, life-saving care immediately. However, remaining in hospital, when life expectancy is limited can considered to be a harm in of itself. Discharge home offers the possibility for an improved quality of life for the child and her family but comes with significant medical risks. When making decisions for children, two ethical models predominate, the promotion of the child's best interests or the avoidance of harm. However, in some circumstances, particularly for children with life-limiting and / or life-threatening illness, all options may be associated with risk. There are no good options, only potentially harmful choices. In this paper we explore decisions made by one family in such circumstances. We describe a model adopted from risk management programmes beyond medicine, that offers a potential framework for identifying risks to the child that are morally permissible. Some risks and harms to a child, not ordinarily permitted, may be acceptable when undertaken in the pursuit of a specified desired good, so long as they are As Low as Reasonably Practicable.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 245.1KB, Terms of use)
-
- Publisher copy:
- 10.1136/jme-2023-109111
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- Journal of Medical Ethics More from this journal
- Volume:
- 50
- Issue:
- 10
- Pages:
- 712-715
- Publication date:
- 2023-12-19
- Acceptance date:
- 2023-11-19
- DOI:
- EISSN:
-
1473-4257
- ISSN:
-
0306-6800
- Language:
-
English
- Keywords:
- Pubs id:
-
1573576
- Local pid:
-
pubs:1573576
- Deposit date:
-
2023-11-29
Terms of use
- Copyright holder:
- Turnham et al
- Copyright date:
- 2023
- Rights statement:
- © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
If you are the owner of this record, you can report an update to it here: Report update to this record