All Posts By

Aleksandra Tolczyk and Leila Hamzi DeWitt

Feb 27 2022
2
Life-Prolonging Therapies in a Case of Anencephaly: A Mother's Wish

Life-Prolonging Therapies in a Case of Anencephaly: A Mother’s Wish

By | Articles, Ethics Consult Reports

Medical futility is often a point of debate in situations of hoping for an unlikely outcome, or a condition with a treatment that necessitates high levels of pain or discomfort. Anencephaly is generally accepted as incompatible with prolonged life, with few infants surviving into the neonatal period. Parents are typically counseled accordingly, resulting in pregnancy termination or comfort care after delivery. This case report examines the ethical considerations involved in the decision to continue life-prolonging treatment of an 8-month-old infant with anencephaly.

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Sep 06 2021
2

More Similar Than Different: Discoveries in Medical Culture when Practicing Global Health at Pediatric Hospital in Ethiopia

By | Peer-Reviewed Articles

Ethiopian physicians, nurses, and midwives routinely encounter cultural challenges created by language barriers, an urban vs rural divide, and differences in education that impact the patient-provider relationship. Despite limitations in personnel and resources, these clinicians have devised approaches to overcome these barriers to best serve their patients.

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Feb 07 2020
5
The Use of Suffering in Pediatric Bioethics and Clinical Literature

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

By | Articles, Peer-Reviewed Articles

“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.

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Dec 27 2020
1
Pediatric Ethicscope: Tomas Jose Silber, Leikin Lecture on Suffering main image: Chiron, Peleus, and Infant Achilles

Leikin Lecture: On Suffering

By | Articles, Peer-Reviewed Articles

So why is it that we clinicians are so often uneasy when talking about patient suffering? One simple explanation would be that, in our era of the most extraordinary scientific discoveries, this topic has been neglected because it is so profoundly subjective, impossible to measure, quantify or compare. I propose an additional explanation; entering the world of suffering compels a response that we are not sure we can deliver. Our doubts originate in shortcomings of the health care system itself, neglect by the educational system, and from the burden of our own suffering.

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Dec 16 2020
6

Competing Interests in Pediatric Eating Disorders Patients

By | Articles, Peer-Reviewed Articles

Use of sedation and restraints is sometimes the only means available to stabilize medically fragile eating disorders patients. While minors are not given the option to refuse care that competent adults are, forced tube feeding nonetheless challenges the minor patient’s senses of identity and control. The following 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.

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Aug 17 2019
3
Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics Evidence based Data driven medicine

Ethical Analysis of Normative Biases In Data-Driven Medicine

By | Articles, Peer-Reviewed Articles

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.

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Aug 15 2019
4
editorial board member Pediatric Ethicscope: the Journal of Pediatric Bioethics and Pediatric Ethics

Considerations for Informed Consent in Clinical Trials Involving Neonates

By | Articles, Peer-Reviewed Articles

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).

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