NEONATAL AND PEDIATRIC CRITICAL CARE: Ethical Decision Making
Section snippets
Legal Issues
The concept of autonomy and capacity to make medical decisions is for minors a relatively new idea. Unlike adults, children are automatically deemed incompetent regardless of their maturity, and parents are required to provide consent for medical care.
States are free, however, to modify this general rule. Some states under case law provide to minors who live alone, are in the military, or have other evidence of independence the legal right to make medical decisions for themselves. Some states
SURROGACY AND THE BEST INTEREST STANDARD
Assigning parents as the medical decision maker for children makes social, logical, and ethical sense. The parents have conceived (or adopted) the child and have raised this child with all associated social, emotional, and legal obligations. The parents in most cases will be living with the child regardless of what the later quality of life is. In most cases, the parents alone are going to have to deal with the child's care requirements. The Supreme Court of the United States has
SUMMARY
Advances in critical care have raised increasingly difficult ethical issues for children. Before major technologic and medical advances such as immunizations, antibiotics, ventilators, and transplantation, parents chose what treatment their child received. As what was possible through medical care expanded, the government assumed the parents' role by requiring aggressive medical treatment for all children regardless of the probable outcome. With ever-increasing technology, however, it has
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Medical Ethics in Pediatric Critical Care
2013, Critical Care ClinicsCitation Excerpt :Along the same lines, others have outlined criteria for what degree of harm justifies the state’s overriding a parental choice or refusal of therapy (Box 1).20 Yet, until such a threshold is reached, any number of choices might be acceptable if harm to the child is avoided or the choice is consistent with the choice that a reasonable parent would make.21 In practice, the parents and the medical team usually navigate these types of choices without explicitly considering what decision-making standards are being applied.
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2021, American Journal of BioethicsOverriding parents' medical decisions for their children: A systematic review of normative literature
2014, Journal of Medical EthicsInformed consent in pediatric practice
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Address reprint requests to Rebecca Cooper, MD, JD, Division of Neonatology, Wolfson Children's Hospital, 800 Prudential Drive, Jacksonville, FL 32207