Ethical considerations on the use of medical technologies for children and youth with complex and chronic conditions

Medical technologies have advanced care for children and youth with complex and chronic conditions both through ‘high tech’ applications (e.g., tracheostomy with mechanical ventilation, ventricular assist devices, long-term parenteral nutrition, dialysis) and less complex supports (e.g., feeding tubes, suctioning equipment, mobility aides). However, there are challenges to consider. These relate to ethical decision-making regarding the use of medical technologies as well as concerns for how technologies may affect children and family experiences, clinical practices, and institutional cultures of care. This position statement draws on the literature to provide key considerations that may help paediatricians and other health care professionals adopt a reflective stance on using medical technologies for children with chronic and complex conditions. It also discusses how these considerations may inform treatment recommendations and shared decision-making, acknowledging that ethical and cultural challenges in this context are both inherent and enduring.