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Peer-Reviewed Articles

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

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

By | Articles, Peer-Reviewed Articles

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.

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Ethics Consult Report: Withdrawal of Artificial Nutrition and Hydration

Ethics Consult Report: Withdrawal of Artificial Nutrition and Hydration

By | Ethics Consult Reports, Peer-Reviewed Articles

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.

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