The ethics of family-centred care for hospitalised children

Family-centred care (FCC) is a well-known concept. Or is it? If one visits just about every children's hospital, child health facility, paediatric health centre and, of late, many adult health services, in just about every country, one willfind policy documents, standards, guidelines, all espousing FCC. A trawl through web sites of 15 children's hospitals in several English-speakingcountries showed that FCC was well known in 13 of them. Policy documents from paediatric health services in non-English-speaking countries will find similar results. Many will agree that FCC is widely recognised and used. But do we really know what FCC is? How is it defined? What does it mean for families? For health professionals? Is it the best model for use with children and their families? Is there an alternative? Does it work in different cultures? And is it ethical for us to continue to use the term so widely if we cannot answer the previous questions adequately? This chapter defines FCC, gives a brief history of its evolution and then examines it using several theories of ethics. The end result is more questions than answers, and a plea for more debate and discussion over a widely applied model for which no real evidence exists.