Full Description
Children in precarious health present particular problems for healthcare professionals because of their intimate relation to their family, and because of the family's need to provide major long-term source of support and to be actively involved in the decisions about their children's care. This collection of cases and commentaries in pediatrics highlights the difficult ethical dilemmas that can arise during high-tech hospital care of children in precarious circumstances. It serves as a teaching tool for clinical ethics and as an introduction for medical students and residents. Clinical cases are described in detail by the physicians involved, who focus on the ethical issues arising during treatment. Each case is then commented on in detail by a philosopher or other bioethicist. It thus serves well as an introduction to contemporary clinical bioethics, but with a firm grounding in the practicalities of real-life pediatric care in the hospital setting.
Contents
Part I. Therapeutic Misalliances: 1a. Unconventional medicine in the pediatric intensive care unit Chester Randle; 1b. Role of responsibility in pediatrics: appeasing or transforming parental demands? Richard B. Miller; 2a. The extremely premature infant at the crossroads Ronald Cohen, Eugene Kim; 2b. The extremely premature infant at the crossroads: ethical and legal considerations Simon Whitney; 3a. Munchausen syndrome by proxy Manuel Garcia-Careaga and John Kerner; 3b. Conceptual and ethical issues in Munchausen syndrome by proxy F. M. Kamm; Part II. Medical Futility: 4a. Letting go: a study in pediatric life-and-death decision making Lawrence H. Mathers; 4b. Near drowning, futility and the limits of shared decision making Simon Whitney; 5a. Long-term ventilation in a child with severe central nervous system impairment Ronald M. Perkin, Robert Orr and Stephen Ashwal; 5b. Autonomy, community and futility: Moral paradigms for the long-term ventilation of severely impaired child Anita Silvers; 6a. Complexities in the management of a brain dead child Lorry Frankel and Chester Randle; 6b. The moral arena in the management of a brain dead child Amnon Goldworth; Part III. Life By Any Means: 7a. Where should a child die? Roger Burne; 7b. Where should a child (in the U.S.) die? William A. Silverman; 8a. Infant heart transplantation and hypoplastic left heart syndrome: what are the ethical issues? Clifford Chin; 8b. Infant heart transplantation and hypoplastic left heart syndrome: a response Joel E. Frader; 9a. Liver and intestinal transplantation Manuel Garcia-Careaga, Ricardo Orlando Castillo and John Kerner; 9b. Transplantation and adolescents Rosamond Rhodes; Part IV. Institutional Impediments to Ethical Action: 10a. Ethics problems encountered with oncology and bone marrow transplant patients Lorry R. Frankel and Joseph V. DiCarlo; 10b. Ethical problems encountered in the intensive care unit with oncology and bone marrow transplant patients Linda Granowetter; 11a. Nursing perspectives on withholding food and fluids in pediatrics Joy Penticuff; 11b. Ethics and clinical decision making: withholding food and information Mary V. Rorty; 12a. Ethics and managed care Douglas S. Diekema; 12b. Challenging fidelity: physicians' role in rationing Nancy S. Jecker; Glossary of terms; Index.
