Coronavirus Update

Dear readers, given the realities of COVID-19, we are making this platform available for sharing resources and information related to the pandemic. Contact the editors if you have information you would like to share with the pediatric ethics community. Currently we are working with our partners in the Boston and Washington, D.C. ethics consortia to share COVID-related policies and practices in an effort to share best practices across children’s hospitals dealing with the pandemic. The button below links to our COVID19 information page.

While the virus isn’t currently resulting in large numbers of pediatric patients, we are now doing expedited peer review of narratives, case reports, and other submissions related to Coronavirus. These will be published on a rolling basis.

A journal devoted to pediatric bioethics

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In Press

Winter 2019;32(2)

Editorial

Pediatric Ethicscope cover 32(2) The Sick Child, Munch

Editorial volume 21 number 2: We have introduced a number of new elements to the Pediatric Ethicscope website over the past several weeks. These changes were prompted by several requests from readers, and most of the changes are aimed at aiding readers wanting to cite and download Pediatric Ethicscope articles for research or teaching purposes. About the cover; about the articles.

Pierre in the Clinic

Pierre in the Clinic draws the parallel between the children's story and pediatric ethics. Pediatric Ethicscope 2019 vol. 32 no. 2.

Disengagement and non-adherence of an adolescent with chronic disease potentially leading to life-threatening complications is a common and distressing challenge encountered by pediatricians. Most clinicians intuitively focus on balancing the patient’s emerging autonomy with beneficence and non-maleficence. We believe ‘good care’ may be better understood through the lens of care ethics.

The Use of Suffering in Pediatric Bioethics and Clinical Literature: A Qualitative Content Analysis

The Use of Suffering in Pediatric Bioethics and Clinical Literature

“Suffering” is a concept that is frequently invoked in discussions about medical decision-making in pediatrics. However, empirical accounts of how the term is used are lacking, creating confusion about the concept and leaving parents and providers unsure about the appropriate ways to account for it in pediatric decision-making. We conducted a qualitative content analysis of pediatric bioethics and clinical literature in selected journals from 2007 to 2017 to determine how authors define and operationalize the term when referring to issues in pediatric treatment.

Current Issue

Spring 2019;32(1)

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2019 Spring Editorial

editorial board member Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics Editorial: normative biases in data-driven medicine; clinical trials involving neonates; medical complexity and foster care; empathy and patient/family worldview; moral courage; ethics of physician shadowing.

Overview of volume 32 issue number 1: Informed consent in neonatal clinical trials, home medical care, biases is data-driven medicine, patient worldviews, moral courage, and physician shadowing.

Ethical Analysis of Normative Biases In Data-Driven Medicine

Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics Evidence based Data driven medicine

Information technology in the 21st century has resulted in physicians coming to rely on data. However, when clinicians are conditioned to rely on data and suppress clinical judgment, it becomes difficult to manage rare conditions where data is not available. The following discussion recounts one family’s experience with clinical counseling on a rare diagnosis and highlights these issues.

Considerations for Informed Consent in Clinical Trials Involving Neonates

editorial board member Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics

Conducting clinical research in newborns requires special protections due to the high vulnerability of this patient population and their parents. This paper presents guidance developed by a multidisciplinary group of bioethicists and patient advocates considering patient- and parent-centric approaches to informed consent in neonatal research in the context of an ongoing clinical trial for neonates with spinal muscular atrophy (SMA).

Medical Complexity Leading to Foster Care

Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics complex medical care can lead to foster care

Pediatric patients who require medical care that is beyond the ability of their family to administer and/or maintain poses numerous ethical questions. Assuming the best interests of the child necessarily compel foster placement, what practical and ethical issues remain?

Empathy and the Divide Between Medical and Patient/Family Worldviews

editorial board member Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics Physician discusses diagnosis with patient's parents.

A lack of empathy while standing in as a translator for another physician's patient and family raised the following question: can one be culturally insensitive to one's own culture? The following narrative explores the divide between medical and patient/family worldviews.

Moral Courage in Practice

Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics moral courage

A nurse recounts her experience as a new NICU nurse raising an issue about the appropriateness of a procedure with the rest of the medical team. The narrative addresses issues of power imbalance, ethical controversy, medical decision-making, and moral distress.

Clinical and Surgical Shadowing: A First-Person Account and Ethical Analysis

Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics Physician shadowing

Shadowing has become, if not an explicit requirement, important for medical school admission. Shadowing has come under criticism for undermining bioethical principles such as patient autonomy and privacy. Critics argue the practice of shadowing violates the physician's fiduciary duty to the patient. These criticisms are largely based either theoretical concerns or anecdote. This account reviews the criticisms of shadowing and assesses the claims.

Ethics Consult Report: Withdrawal of Artificial Nutrition and Hydration

Ethics Consult Report: Withdrawal of Artificial Nutrition and Hydration

A medical team considers withdrawal of artificial nutrition and hydration supporting a 6-month-old girl with complex cardiac disease, devastating neurological injury, and ongoing, unmanageable pain. Diffuse neurological injury and severe ischemia in all four limbs offers a bleak prognosis. Drawing on the bioethics literature on the subject, the following case presentation and analysis illustrates how a medical team and family can approach such a situation.

Clinical Ethics Consult Commentary: Promoting Human-Centered Care

Withdrawal of Artificial Nutrition and Hydration Ethics Consult Commentary

When technologically advanced medicine fails to “rescue [a patient] intact from the conditions of her birth,” professionals must rely even more squarely on the foundation of good medicine – human-centered caring. While we do not disagree with Mr. Teti’s ethical analysis, we believe that ethics consultants can (and should) do more to support the medical team in achieving this foundational goal.

Pediatric Ethicscope at a Glance

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Journal

Pediatric Ethicscope: The Journal of Pediatric Bioethics is a peer-reviewed clinical and academic journal dedicated to presenting the work of multidisciplinary contributors sharing diverse, nuanced perspectives on issues in pediatric ethics, bioethics and clinical ethics. In an effort to democratize knowledge of the important issues in pediatric ethics, the journal is OA platinum; we charge fees to neither readers nor authors. This is made possible by support from our home institution, the Harvard Medical School Center for Bioethics.

Editorial Board

The Pediatric Ethicscope editorial board is comprised by renown experts in the field of pediatric ethics, bioethics, and clinical ethics. More can be read about each of the board members here.

Douglas S Diekema MD, MPH
Jacqueline Glover PhD
John Lantos MD
Christine Mitchell RN, MS, MTS
Jonathon Moreno PhD
Mark Mercurio MD, MA
Lainie Ross MD, PhD
Cynda Rushton PhD, RN, FAAN
Yoram Unguru MD, MS, MA

Readership

Being Open Access Platinum, Pediatric Ethicscope has a broad readership. While most readers are located in the United States and Canada, overall readership spans more than 100 countries. The journal is archived by the library of Congress (ISSN Print 2328-4617, ISSN Online 2328-4625). Below: Geographic distribution of readers denoted in blue, with darker tones indicating greater numbers.

Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics worldwide readership

Submissions

Pediatric Ethicscope has been published biannually for the past 32 years, and more about the journal’s history can be found here. The journal publishes original research, review articles, case studies, short and long form issue analyses, grand rounds, point/counterpoint segments, interviews with prominent ethicists, book reviews, and reports on ethics education opportunities.

The journal accepts manuscripts in all aforementioned categories within our defined scope: issues in pediatric ethics, pediatric clinical ethics cases and practices, and matters of bioethics policy affecting children and families. Please see For Authors for more information on our submittal and peer-review processes, and contact the editors with any further questions.

Issues are released both online and in print. The online, HTML versions can be found below. Following online issue, PDFs  of the print version can be read online or downloaded using the link, “Download Print Version PDF” to the right of this text. Please note past issues are available both online and in downloadable PDF versions under the Archives  tab. Thank you for your interest in Pediatric Ethicscope.

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