Pediatric Collections: Ethics Rounds: A Casebook in Pediatric Bioethics

The ethical issues that arise in pediatrics are very different from those that arise in other clinical settings. The differences arise partly because young children cannot make decisions for themselves. Thus, the principle of autonomy, a principle that is so important in resolving the dilemmas that arise in the care of adults, is irrelevant in ethical dilemmas involving young children. It is partially relevant in older children and adolescents. Furthermore, autonomy is, essentially, a procedural principle. It doesn’t claim to determine what choice is right. It only specifies who should be empowered to make the decision about what is right. Without the ability to fall back on autonomy, doctors, parents, and ethicists who are caring for children must make substantive decisions about what is best for those children. To do so, they rely on a number of ethical considerations. This collection presents a series of cases that highlight some ethical dilemmas that arise in pediatrics.