Clinical Ethics in Pediatrics A Case-Based Textbook

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.

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.

Douglas S. Diekema is a Professor of Pediatrics at the University of Washington School of Medicine with adjunct appointments in the Departments of Bioethics and Humanities and Internal Medicine in the School of Medicine and the Department of Health Services in the School of Public Health. He is also an attending physician in the emergency department at Seattle Children's Hospital and serves as Director of Education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Hospital. He has been a member of the Seattle Children's Hospital ethics committee since 1991, has served as an ethics consultant since 1993, and has been chairperson of the institutional review board since 2000. He is past Chair of the Committee on Bioethics of the American Academy of Pediatrics. Dr Diekema is the author of numerous scholarly publications in medical ethics and pediatric emergency medicine.
Mark R. Mercurio is Associate Professor of Pediatrics and Director of the Program for Biomedical Ethics, Yale University School of Medicine, New Haven, CT, USA.
Mary B. Adam is a pediatrician from the University of Arizona, Tucson, AZ, USA. She currently works in medical education and public health in Kenya.