Ethical Issues in Pediatric Life-Threatening Illness: Dilemmas of Consent, Assent, and Communication
Ethics and Behavior. 1997; 7(1): 43-57.
The treatment of life-threatening illnesses in childhood is replete with ethical issues and with clinical issues that have ethical implications. The central issues are those involved with a child's participation in the decision-making process and with communication of information about the illness and treatments to children. This article examines the questions of patient autonomy and of parental responsibility and prerogative in the context of pediatric oncology. Included in this examination of the ethical dimensions of pediatric life-threatening illness is a discussion of the many related aspects involved, including medical, cultural, psychosocial, legal, and developmental. A multidimensional approach that considers the ways in which these multiple aspects interact with one another, and which focuses on establishing a strong working alliance between the health care team and the pediatric patient's family, can help to avoid or resolve potential ethical and clinical conflicts.
Adolescents; Age Factors; Allowing to Die; Autonomy; Beneficence; Cancer; Case Studies; Children; Communication; Competence; Consent; Deception; Decision Making; Diagnosis; Disclosure; Dissent; Emotions; Family Relationship; Futility; Health; Health Care; Informed Consent; Illness; Justice; Legal Aspects; Life; Minority Groups; Minors; Nontherapeutic Research; Palliative Care; Parental Consent; Parents; Patient Care; Patient Care Team; Patient Participation; Pediatrics; Professional Family Relationship; Prognosis; Prolongation of Life; Research; Resuscitation; Resuscitation Orders; Risks and Benefits; Social Workers; Trust; Truth Disclosure;
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