Deciding with Children S2 Ep3: Finding My Voice

Transition to adult services is an important step for patients who have been cared for in a children’s hospital or by a paediatrician. This is a process (transition) rather than an event (transfer) and takes both time and careful curation for the young person and their parents. The goal is to help develop the young person as an independent medical decision-maker at the same time as facilitating the parents’ role to switch from parent to patient advocate. There are many barriers to transition: willingness of the clinician to ‘let-go’; the patient's and parents' fears about a new environment and healthcare team; difficultly of the young person stepping-up into a role as independent decision-maker; difficulty of the parent ‘letting-go’ or shifting roles, and perhaps a poorly established medical service for young people with complex healthcare needs. Nevertheless, the process of transition needs to occur to promote the autonomy and best interests of the child and, in a call to justice, to make room for younger children who need paediatric services. Host: Prof John Massie. Guest: Evelyn Culnane, RCH Transition Service. Ethicist: Prof Clare Delany, Children’s Bioethics Centre, The Royal Children's Hospital, Melbourne, Australia.