Der Bruch ethischer Normen durch die Ökonomisierung in der Kinder- und Jugendmedizin: Stellungnahme der Kommission für ethische Fragen der Deutschen Akademie für Kinder- und Jugendmedizin (DAKJ)

The increasing commercialization of the German healthcare system is compromising medical care for children and adolescents. Superficial economic decisions influence medical and nursing care, which in effect should be based primarily on medical ethics aspects. Due to the structure of the current healthcare system, and much to the detriment of the younger generation, medical facilities for children operate in deficit and therefore may be shut down. There is also a substantial shortage of staff, threatening future comprehensive nationwide pediatric care. This report highlights quality deficiencies in patient care, potential violation of ethical norms, along with the relevant legal provisions and international agreements. Funding for pediatric facilities through the current DRG-based system infringes on the rights and special needs of sick children and adolescents by providing inadequate financial compensation. The need to protect the developmental aspects of young people are not sufficiently recognized in our society. The principle of solidarity, which is the basis for the fair and equitable distribution of health resources, is thereby violated. Quality may suffer when there are not enough skilled workers to provide the labor-intensive, specialized care required for children. The capacities are becoming particularly scarce in the outpatient setting. Simultaneously, there is a shift in demand from inpatient to outpatient services. Priority must be given to all measures aimed at promoting health and a healthy lifestyle for children and adolescents, including education and recreational activities. In order to effectively safeguard the rights of sick children and adolescents, the German Academy for Pediatric and Adolescent Medicine (DAKJ) demands strict compliance with all relevant standards of medical ethics as well as with all current and future legal provisions. Underfunding needs to be immediately addressed and training facilities for pediatric nursing care must be expanded.