Lecture VII: Ethics in the Care of Children Flashcards
Identify conflicts that can arise even when everyone wants what is in the best interest of the pediatric patient
- Treatment is always a trial
- benefits>burdens
Infants
• Clearly lack decision making capacity
• Natural surrogate decision maker is the parent
• Must use the best interest standard as the basis for decision making: “Assess the nature and consequences of proposed options and choose one that offers the most benefit for the patient”
Beneficence – Duty to assist patients in need
• Respect for natural rights of parents to make decisions for their children
• Third parties may oppose decisions made by parents, ostensibly acting in the best interest of the child (parents don’t “own” their children - doctors need to promote the best interest of the child)
Identify that a process is needed to resolve these disputes
Four Box Model:
- medical indications
- quality of life
- patient preferences
- contextual features
Describe a hospital Ethics Committee’s role and function, and its relationship to the courts.
The HEC is used to help resolve issues that occur when there is a disagreement within the treatment team or between the treatment team and the patient/surrogates of the patient (if the patient isn’t competent). Ethics is not law and can determine what should be done, but not necessarily what must be done legally. At times, the committee refers cases to the courts if the surrogate of the patient is deemed neglectful. However, once this occurs, the court usually takes control of the case and is thus used as a last resort in most cases.
