Abstract
The chapter starts with the ethical issues related to a severely handicapped newborn, a condition that often requires a series of medical and surgical interventions. When chances for long-term survival and life without continuous significant medical support are slim or non-existent, the attitude of the parents towards intensive medicine or palliative care should be considered. In most other situations in pediatrics, however, the ethical validity of decisions made by parents or caregivers is not a question of autonomy of surrogate decision-makers but should be based on the principle of beneficence towards the child. Even if the autonomy of a child is limited, it should be respected to the highest reasonable level, and any medical intervention should be accompanied with an appropriate explanation. The chapter includes discussion of some topics specific to the young: mandatory vaccination, suspected child abuse, genetic testing in childhood, reactions to the death of a child, and clinical research in a pediatric population.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
In 1998, Andrew Wakefield published an article in The Lancet in which he supposedly proved that vaccination against measles, mumps, and rubella can be the cause of autism and colitis. It was later confirmed that the data in the article were forged. Dr. Wakefield’s medical license in Great Britain was revoked.
- 2.
Recently, Dr. Urh Grošelj presented an interesting comparison that can be used when trying to convince others why vaccination in healthy children is justified. Everyone agrees that it is safer for the baby in a car to be fastened in the child safety seat. Even if once in every 10,000 accidents it happens that a child is severely injured due to the safety belt, we will not oppose the use of child safety seat on the basis of this single case. Similar holds for vaccination: it is unreasonable to reject a measure, which is undoubtedly beneficial to the majority of children, due to very rare instances of complications.
- 3.
In 2015, Nuffield Council on Bioethics published recommendations on participation of children in clinical research: http://nuffieldbioethics.org/wp-content/uploads/Children-and-clinical-research-full-report.pdf.
References
Mesina V, Mangels AR. Considerations in planning vegan diets: children. J Am Diet Assoc. 2001;10:661–9.
Suggested Reading
Botkin JR. Ethical issues in pediatric genetic testing and screening. Curr Opin Pediatr. 2016;28:700–4.
Chervenak FA, McCullough LB. Healthcare justice and human rights in perinatal medicine. Semin Perinatol. 2016;40:234–6. https://doi.org/10.1053/j.semperi.2015.12.011.
Chervenak FA, McCullough LB. Ethics in perinatal medicine: a global perspective. Semin Fetal Neonatal Med. 2015;20:364–7. https://doi.org/10.1016/j.siny.2015.05.003.
Grootens-Wiegers P, Hein IM, van den Broek JM, de Vries MC. Medical decision-making in children and adolescents: developmental and neuroscientific aspects. BMC Pediatr. 2017;17:120. https://doi.org/10.1186/s12887-017-0869-x.
Hein IM, De Vries MC, Troost PW, Meynen G, Van Goudoever JB, Lindauer RJ. Informed consent instead of assent is appropriate in children from the age of twelve: policy implications of new findings on children’s competence to consent to clinical research. BMC Med Ethics. 2015;16:76. https://doi.org/10.1186/s12910-015-0067-z.
Hoytema van Konijnenburg EM, Teeuw AH, Ploem MC. Data research on child abuse and neglect without informed consent? Balancing interests under Dutch law. Eur J Pediatr. 2015;174:1573–8. https://doi.org/10.1007/s00431-015-2649-7.
Orzalesi M, Danhaive O. Ethical problems with neonatal screening. Ann Ist Super Sanita. 2009;45:325–30. Review. PMID: 19861738.
Parasidis E, Opel DJ. Parental refusal of childhood vaccines and medical neglect laws. Am J Public Health. 2017;107:68–71.
Rapoport A, Morrison W. No child is an island: ethical considerations in end-of-life care for children and their families. Curr Opin Support Palliat Care. 2016;10:196–200. https://doi.org/10.1097/SPC.0000000000000226.
Rosenberg AR, Starks H, Unguru Y, Feudtner C, Diekema D. Truth telling in the setting of cultural differences and incurable pediatric illness: a review. JAMA Pediatr. 2017;171:1113–9. https://doi.org/10.1001/jamapediatrics.2017.2568.
Schilling S, Christian CW. Child physical abuse and neglect. Child Adolesc Psychiatr Clin N Am. 2014;23:309–319, ix. https://doi.org/10.1016/j.chc.2014.01.001.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Zwitter, M. (2019). Pediatrics. In: Medical Ethics in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-00719-5_14
Download citation
DOI: https://doi.org/10.1007/978-3-030-00719-5_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-00718-8
Online ISBN: 978-3-030-00719-5
eBook Packages: MedicineMedicine (R0)