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.
How did we get here? Mara, now nearly 17-years-old, was born with a neurogenic bladder. Up until two years ago, she was a model patient. No one worried about her adherence with self-catheterization or medications. She was optimistic about her future, cared about her health, and we looked forward to her bright and open future. But now Mara says,
“I don’t care.”
Doctors revise their diagnostic strategy to provide a timely and meaningful prognosis in accordance with parental goals. This narrative discusses issues of diagnostic uncertainty and the value of relying on clinical gestalt when trying to prioritize medical tests for a sick patient.
Since Henry Beecher’s 1966 revelation of the scandal at the Willowbrook School, the ethics of biomedical research involving pediatric subjects has never been the same. Throughout history, the conversation about non-therapeutic pediatric research has moved from access to protection only to return to access once more.
The ethical issues in pediatrics can vary considerably from those in adult medicine. Thus, ethics education generalized for adult care is not necessarily relevant to the specific issues that arise in pediatric settings. The Children’s Mercy Bioethics Center’s Certificate Program in Pediatric Bioethics is the only program in the world that focuses exclusively on pediatrics.