This book examines the many ethical issues that are encountered in the Pediatric Intensive Care Unit (PICU). It supports pediatricians, nurses, residents, and other providers in their daily management of critically ill children with the dilemmas that arise. It begins by examining the evolution of pediatric critical care, and who is now impacted by this advancing medical technology. Subsequent chapters explore specific ethical concerns and controversies that are commonly encountered. These topics include how to conduct end-of-life discussions with families facing a myriad of challenging choices. It goes on to explore the concept of futility, and what that does and does not mean in the pediatric ICU setting. Controversial subjects such as children as organ donors, particularly using donation after cardiac death, in addition to issues surrounding the declaration of brain death are covered. Additional chapters address resource allocation, and also analyze the use of long-term technology in chronically critically ill children. Chapters include case examples with guidance on how to work through similar difficulties and decision-making. While this book is specifically targeted for care providers at the ICU bedside, it is also of benefit to medical students, students in bioethics, practicing ethical consultants and families who are dealing with critically ill children.

Most neonates who now survive intensive care would have died 50 years ago, and “nature” would have decided the outcomes, making ethical discussions about initiating or withholding resuscitation irrelevant. Medical developments in neonatology have changed the way we respond to diseases of neonates, to their illness, and to their parents. Not only as physicians, but also as a society. Decisions on when to start, withhold, or withdraw life-saving interventions in critically ill neonates are among the most difficult decisions in pediatric practice. These decisions are fraught with ethical dilemmas, for example deciding whether withholding intensive care –leading to death- is superior to uncertain survival with a risk of disability and the additional burden of intensive care. This book covers important ethical questions that arise in neonatal intensive care units. Questions such as, whether to intervene medically and whether we are good at predicting the outcome of fragile neonates; whether a medical intervention should be withheld or withdrawn, and who should be primarily responsible for these decisions and how?

This book assists health care providers to understand the specific interplay of the roles and relationships currently forming the debates in pediatric clinical ethics. It builds on the fact that, unlike adult medical ethics, pediatric ethics begins within an acutely and powerfully experienced dynamic of patient-family-state-physician relationship. The book provides a unique perspective as it interacts with established approaches as well as recent developments in pediatric ethics theory, and then explores these developments further through cases. The book first focuses on setting the stage by introducing a theoretical framework and elaborating how pediatric ethics differ from non-pediatric ethics. It approaches different theoretical frameworks in a critical manner drawing on their strengths and weaknesses. It helps the reader in developing an ability to engage in ethical reasoning and moral deliberation in order to focus on the wellbeing of the child as the main participant in the ethical deliberation, as well as to be able to identify the child’s moral claims. The second section of the book focuses on the practical application of these theoretical frameworks and discusses specific areas pertaining to decision-making. These are: the critically ill child, new and enduring ethical controversies, and social justice at large, the latter of which includes looking at the child’s place in society, access to healthcare, social determinants of health, and vaccinations. With the dynamic changes and challenges pediatric care faces across the globe, as well as the changing face of new technologies, no professional working in the field of pediatrics can afford not to take due note of this resource.

Pediatric Ethicshas been written by experienced pediatric caregivers. All the most difficult and challenging pediatric issues are faced, from truth-telling for the child to confidentiality for the adolescent and from 'futility' in intensive care to conflicting interests in the private office. This book has been specifically designed to enhance the practitioner's ability to identify, evaluate and manage the real ethical problems that arise in caring for children and their families.

Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family's need to provide major long-term source of support and to be actively involved in the decisions about their children's care. This collection of cases and commentaries in pediatrics highlights the difficult ethical dilemmas that can arise during high-tech hospital care of children in precarious circumstances. It serves as a teaching tool for clinical ethics and as an introduction for medical students and residents. Clinical cases are described in detail by the physicians involved, who focus on the ethical issues arising during treatment. Each case is then commented on in detail by a philosopher or other bioethicist. It thus serves well as an introduction to contemporary clinical bioethics, but with a firm grounding in the practicalities of real-life pediatric care in the hospital setting.

Should every child be vaccinated before being allowed to go to school? Should children be allowed to refuse medical treatment even if it might save their life? Does the fetus or unborn child have any rights? Is it acceptable for a child’s family to demand an expensive treatment despite uncertain benefits? If you are a healthcare professional involved in the care of children, how would you even begin to approach these dilemmas? This book provides a unique resource; it is a concise, practical case-based interactive workbook which will help the reader critically think about, and approach, ethical problems in child health. Its key features include an introduction to medical ethics in child health; a method to approach clinical ethical dilemmas; interactive case studies; and thought-provoking discussions. It will be particularly helpful for undergraduate medical and nursing students, post-graduate paediatric trainees, paediatric nurses and allied health professionals.

This book examines the many ethical issues related to health and health care in children. It describes the field of Pediatric ethics, a unique and important aspect of the discipline of bioethics, the study of moral conduct in health care and the rational process for determining the best course of action in the face of conflicting choices. The book begins with an exploration of what it means to be a child in America and the unique kinship relationships and obligations engendered by the decision of parents to have a child, and it examines ethical principles and professional obligations related to the care of children. Each of the chapters in the book focuses on important ethical concerns. It begins with ethical issues in creating babies using reproductive technologies, and then continues with an analysis of the ethical issues in labor and delivery of a child. The book continues with an in depth analysis of the many hard choices faced by families and clinicians in the care of critically ill neonates, and then goes on to describe current controversies in caring for older children who are dying and their families, as well as ethical issues concerning adolescents, research ethics as it relates to children, issues concerning genetic testing, screening and biobanking, and surgical and medical enhancement of children. Each chapter has case examples to illustrate the real life concerns of patients, families and clinicians. The book is intended for students in pediatrics and ethics, as well as for practicing clinicians, and interested families.