Bioethics In The Pediatric Icu Ethical Dilemmas Encountered In The Care Of Critically Ill Children

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?

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.

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.

The questions and dilemmas of bioethics touch everyone. Should people who refuse to be vaccinated be treated for COVID-19, even if that displaces vaccinated patients with other serious conditions? What restrictions on abortion should there be, if any? Should women be paid to donate eggs? Bioethics: What Everyone Needs to Know ® discusses these and other similar questions facing the public today--as well as providing a way for thinking deeply about them. Steinbock and Menzel first examine major moral theories and how they can be used to analyze bioethical issues. They then provide historical background to the birth of bioethics and explain how it shifted from a paternalistic doctor knows best approach to respect for autonomy, a fundamental value in contemporary bioethics. Subsequent chapters cover advance directives, experimentation on human subjects, the definition of death, physician-assisted dying, abortion, disability, just healthcare systems, the allocation of scarce resources, pharmaceutical drug pricing, assisted reproductive technology, egg donation, surrogate motherhood, sex selection, and the genetic modification of humans. Race and gender are considered throughout, as are the ethical issues raised by pandemics. Steinbock and Menzel consider the controversial questions that surface in the public sphere, explaining the facts, and then evaluating different approaches to resolving them.

Recent Advances in Paediatrics-29 features an outstanding collection of articles relevant to paediatricians and health professionals working with children and adolescents across the world. The book reflects the changing landscape in paediatrics, with significant emphasis on adolescent health, both physical and mental, and references the role of technology and innovations such as conversational artificial intelligence (AI) and ChatGPT in improving outcomes. Other topics include prenatal screening and diagnosis of genetic defects, advances in neonatal care, a systematic approach towards orthopaedic management of cerebral palsy, bone health and osteoporosis, as well as advances in surgery and urology. The text features chapters on “safer care for sick children” with the role of safety checklists and escalation of care using hub and spoke models covered in depth to encourage universal high standards of care. This book is a compelling read for medical students explaining aspects of paediatrics often not covered in conventional textbooks, and furthermore provides an effective revision tool for DCH and MRCPCH examinations. It will also be of interest to practising clinicians wishing to keep up to date with the latest advances in their field. All chapters are written by expert authors ensuring authoritative and accurate content, and full colour photographs supplement enhance the comprehensive text.

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.

This work examines the many ethical issues related to health care in children. It explores the moral obligations of families and clinicians facing hard choices for critically ill and dying children, ranging from neonates to adolescents. It also addresses the ethical concerns in research, genetic testing and screening, and surgical and medical enhancement