Meet Unique Challenges of Pediatric Ethics Consults
Many ethicists consult on pediatric cases only rarely. A recent paper addressed some unique considerations.1
“We wanted to highlight some features, both theoretical and practical, that those practicing in the pediatric setting should be aware of,” says Caroline A. Buchanan, PhD, HEC-C, an assistant professor in the program for bioethics and a member of the hospital ethics committee at University of Kentucky College of Medicine.
The authors saw a need for standardization in both education and training for pediatric ethics consultants. “Certain features of pediatric units may differ from adult ones,” Buchanan observes. The paper covers some unique issues that arise during pediatric consults. These include pediatric assent, theories of parental authority, and family-centered care for pediatric patients.
The process of pediatric ethics consultation also is somewhat different. Here are some examples:
- Pediatric cases involve multiple decision-makers; often a triad of the medical team, the patient, and the parents. “Communication skills, then, are especially important,” Buchanan notes.
- Pediatric units often are highly interdisciplinary. “This requires careful information-gathering by an ethicist, and sensitivity toward multiple individuals who have invested time and care toward their patient,” Buchanan explains.
- Pediatric ethicists also should be prepared to follow patients throughout their stay, if necessary, supporting the team as treatment plans progress.
- Consultants also must be familiar with common difficulties in determining beneficent care for pediatric patients. Some treatments may carry a high variability in outcomes.
“Others may have the threat of long-term disability or chronic complications, or permanent effects on the patient’s ability to reproduce or engage in other aspects of their later life,” Buchanan adds.
- Buchanan CA, Bester JC, Bruno B, et al. Pediatric ethics consultation: Practical considerations for the clinical ethics consultant. J Clin Ethics 2019;30:270-283.
Researchers find a need for standardization in both education and training for pediatric ethics consultants.
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