Category

Peer-Reviewed Articles

Psychological and Medical Evaluations: Asylum Seekers, Ethics, and the Law

Psychological and Medical Evaluations: Asylum Seekers, Ethics, and the Law

By | Articles, Peer-Reviewed Articles

This article highlights the importance of psychological and medical evaluations for asylum seekers in the United States, and identifies physicians and other healthcare professionals as uniquely situated for this work. This paper outlines the benefits and drawbacks to such evaluations and addresses their utility in immigration law, ultimately calling for increased clinician involvement in pro bono evaluations.

Read More

Conceptual Considerations for Trainees in Asylum Medicine

By | Articles, Peer-Reviewed Articles

In recent years, the unique role of medical professionals in the asylum adjudication process has been thrown into sharp relief as asylum applications surge, with over one million pending cases backlogged in the U.S. asylum system as of August 2019. Medical evaluations dramatically increase the likelihood of an individual obtaining asylum. The author examines the role medical trainees play in this process.

Read More
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.

Read More

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.

Read More
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.

Read More
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.

Read More

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.

Read More