Dear readers, after a series of delays due to COVID-19, Pediatric Ethicscope will be resuming its regular publication cycle. Articles from our 2020 queue will be added weekly. Thank you for your patience.
A journal devoted to pediatric bioethics
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.
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.
Use of sedation and restraints is sometimes the only means available to stabilize medically fragile eating disorders patients. This case study chronicles the management of an 11-year-old patient transferred from inpatient child psychiatry unit to the adolescent medicine service for nutritional rehabilitation.
“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.
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.
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.
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).
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?
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.
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.
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.
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.
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
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.
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.
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 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.