Clinical Ethics in Pediatrics

This volume provides a practical overview of the ethical issues arising in pediatric practice. The case-based approach grounds the bioethical concepts in real-life situations, covering a broad range of important and controversial topics, including informed consent, confidentiality, truthfulness and fidelity, ethical issues relating to perinatology and neonatology, end-of-life issues, new technologies, and problems of justice and public health in pediatrics. A dedicated section also addresses the topics of professionalism, including boundary issues, conflicts of interests and relationships with industry, ethical issues arising during training, and dealing with the impaired or unethical colleague. Each chapter contains a summary of the key issues covered and recommendations for approaching similar situations in other contexts. Clinical Ethics in Pediatrics: A Case-Based Textbook is an essential resource for all physicians who care for children, as well as medical educators, residents and scholars in clinical bioethics. Features • Provides a practical case-based overview of the ethical issues faced by those caring for children in a healthcare environment • Covers professional topics not traditionally addressed by pediatric ethics books, including boundary issues, the impaired provider and relationships with industry • Includes practical summaries and recommendations, making this a key resource for clinicians, educators and trainees Table of Contents Preface Part I. Core Issues in Clinical Pediatric Ethics: 1. Pediatric decision-making: informed consent, parental permission, and child assent Yoram Unguru 2. Pediatric decision-making: adolescent patients Jessica Berg 3. Refusal of recommended treatment Douglas S. Diekema 4. Adolescent confidentiality Malcolm Parker 5. Adolescent refusals of intervention (and the non-compliant adolescent) Maureen Kelley 6. Family beliefs and the medical care of children Roger Worthington and Mark R. Mercurio 7. Fidelity and truthfulness in the pediatric setting: withholding information from children and adolescents Christine Harrison 8. Fidelity and truthfulness: disclosure of errors Tom Gallagher and David Loren 9. Requests for 'non-therapeutic' interventions in children Anthony J. Thomas and Charlisse Caga-Anan Part II. Ethical Issues at the Beginning of Life: Perinatology and Neonatology: 10. Maternal-fetal conflicts Mark R. Mercurio and Christy Cummings 11. Fetal interventions and fetal care centers Steven Leuthner 12. Assisted reproductive technology, multiple births, and the welfare of the child Jeffrey L. Ecker and Howard L. Minkoff 13. Preimplantation and prenatal genetic testing for inherited diseases, dispositions, and traits Jeff Botkin 14. Decision-making in the delivery room Mark R. Mercurio 15. Withholding and withdrawing life-sustaining intervention from neonates Andrew Beckstrom and David Woodrum 16. The role of QoL assessments in the delivery room and NICU A. Wyatt 17. International variations in newborn care Annie Janvier and John D. Lantos Part III. Ethical Issues at the End of Life in Pediatrics: 18. End-of-life care Joel Frader and Kelly Michelson 19. Futility Norman Fost 20. Advance directives and DNR orders Jeffrey Burns 21. Definition of death Geoffrey Miller 22. Physician aid in dying in children: physician-assisted death – terminal sedation and children Alex Kon 23. The Groningen protocol Eduard Verhagen 24. Symptom management in dying children Marcia Levetown Part IV. Ethical Issues Posed by Advances in Medical Technology and Science: 25. Organ transplantation and the child donor Joel Frader and Aviva Goldberg 26. Enhancement technologies and children Todd Varness 27. Cochlear implants and deaf children Halle Salas 28. Management of disorders of sexual differentiation Joel Frader 29. Sterilizing procedures in minors with cognitive disabilities Don Brunnquell 30. Parental requests for intervention on behalf of children with severe life-limiting conditions with poor quality of life (trisomy 13 and 18) Ben Wilfond 31. Genetic screening and testing Lainie F. Ross 32. The introduction of innovative technology in practice John D. Lantos 33. Human subjects research involving children Erik D. Kodish and Valerie Blake Part V. Children, Public Health and Justice: 34. Resource allocation and triage in disasters and pandemics Jeffrey Burns 35. Parental refusals of vaccination and school vaccine mandates: balancing parental freedom, child welfare, and public health Douglas Opel and Douglas S. Diekema 36. Solid organ transplantation and children with developmental disabilities David C. Magnus 37. Special issues related to the care of orphans Maureen Kelley Part VI. Special Topics in Pediatric Ethics: 38. Conflicts of interest, relationships with industry, and gifts D. Micah Hester 39. Training issues and learning new procedures Armand Antommaria 40. Boundary issues Ian Holzman 41. Ethics consultation and ethics committees Denise Dudzinski 42. Physician coverage of community events that appear to conflict with public health and professional goals: the case of physician coverage at youth boxing events Stephanya Shear and Douglas Opel 43. The impaired, incompetent, or unethical provider Douglas S. Diekema Index.