Ethical issues in care of children with multiple disabilities

Polyhandicap is a French term, defining a state of multiple and severe deficiencies, with motor and cognitive impairment, and needs recognized as specific within the people with multiple disabilities. It associates a clinical fragility, bound to the accumulation of deficiencies of organs and systems, and an extreme vulnerability by the nature and the degree of dependence on others. The therapeutic needs for these "polyhandicapped" children can be a matter of the physical medicine and the rehabilitation, and the paediatric palliative care, simultaneously or at different moments of their life. Both professional models share common aims and also have specific objectives, but they are both hustled by these patients. Every approach is considered from the angle of its singular contribution and its limits. The ethical risk of the care to the "polyhandicapped" children is to mistake an interrogation at a point of the medical history, and the elaboration of all the care. (C) 2018 Elsevier Masson SAS. All rights reserved.