Fall 2017 Volume 30 Issue 1

Proem

An opening thought: sometimes cases in clinical ethics conclude, but leave a thought that remains just out of reach. In the wake of the case, a nagging sense of something meaningful yet elusive, like a broken outline, or a silhouette that can't quite be brought into focus–remains. We invite you to consider the following.

Introducing Pediatric Ethicscope

As we launch online as an open-access journal, Pediatric Ethicscope is now entering its 30th volume; it has, and will continue, to present the work of multidisciplinary contributors sharing diverse and nuanced perspectives on issues of import to pediatric medical ethics. Our aim is to disseminate the best and latest thinking on pediatric ethics. This is how we got here...

Shortages of Drugs, Surpluses of Ethical Challenges

pediatric cancer patient

Shortages of life-saving chemotherapeutics and supportive care agents are pervasive and enduring. These shortages represent a true public health crisis. In the United States, shortages of drugs, including chemotherapy and supportive care agents, have become a “new normal.”

Drug Shortages at Children’s National

Jeffrey Dome MD, PhD, the Division Chief of Hematology and Oncology at Children's National, sat down with Pediatric Ethicscope to discuss the impact of drug shortages and how they are managed a large pediatric institution.

Grand Rounds

A set of twins was transferred to NICU; 25-weekers who came in for a neurosurgery consult on Friday. They both had significant brain bleeds, white matter loss, and hydrocephalus. One of the infants was better off than the other, but both had midline shift and were seizing. Physician and ethicist Yoram Unguru MA, MS, MD discusses the case.

Transitional Care for Adolescents: From Concept to Practice

Clinicians in the adult system are infrequently prepared to treat the variety of conditions seen in pediatrics, and the few providers who are available to this population struggle to absorb the growing number of older patients with childhood-onset disorders. Patients are frequently ill prepared to take on the responsibilities required to manage their own care; the pediatric system lacks functional processes for teaching patients how to develop these skills. Marcela Monti discusses transitional care for adolescents.

Shortages: The New Normal in Pharmacy

In recent years, dealing with drug shortages has become an integral part of a pharmacists work. Learn about the causes, management, and prevention from the pharmacists' perspective.

What Lies Beneath

The issue of drug shortages can be framed as those who wish to ensure drug availability in virtue of dedication to the patients’ interests, on one hand, and those who herald economic responsibilities, on the other. A historical and philosophical account of the problem.

From Classroom to Clinic

Students rush into the halls to watch another fight. While some hoot and holler, others whisper, “they belong at Hartgrove.” Former south side of Chicago teacher, Joseph Lee MD discusses his journey from teacher to physician.

Ethics Education: Harvard Clinical Bioethics Course

From July 7 through July 9th 2016, the Harvard Center for Bioethics held its annual Harvard Clinical Bioethics Course at the Harvard Medical School in Boston. Nearly thirty hours of lectures, discussion groups, working lunches, and even a play were presented over those three days. Pediatric Ethicscope reports.