Pediatric Bioethics

Why the Dutch Keep Pediatric Euthanasia Illegal

Eduard Verhagen

Pediatric euthanasia in The Netherlands has a unique legal status - it is illegal, openly practiced, and well-regulated. The most surprising part isn't the law that enabled this — it's what happened after.

Associations of Physician Perspectives, Personal Choices, and Counseling for Severe Congenital Heart Defects

Joyce Woo, et al.

OBJECTIVE: To assess whether physicians' perspectives of outcomes or personal choices are associated with prenatal counseling for termination of pregnancy (TOP) or perinatal hospice for severe congenital heart defects (CHDs). METHOD:…

Variation in the extent to which patient information leaflets describe potential benefits and harms of trial interventions: a commentary

Jeremy Howick, et al.

Clinical trial participants must understand the possible risks and benefits of trial interventions before providing their informed consent to participate. The aim of this commentary is twofold: to summarize the discrepancies in the extent…

Pediatric Gender Medicine—Reply

Moti Gorin, Jilles Smids

Third, emerging evidence suggests that modulating glycosylation pathways could offer a novel therapeutic strategy for asthma management.Xie et al 5 proposed that targeting glycan recognition receptors, such as sialic acid-binding…

The Philosophical Fiction of Substituted Judgment

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Variation in the extent to which patient information leaflets describe potential benefits and harms of trial interventions: a commentary.

Howick J, et al.

Clinical trial participants must understand the possible risks and benefits of trial interventions before providing their informed consent to participate. The aim of this commentary is twofold: to summarize the discrepancies in the extent…

Toward Evidence-Based and Ethical Pediatric Gender Medicine

Moti Gorin, Jilles Smids

This Viewpoint discusses the need for clinicians to conduct thorough research on the risks and benefits of gender-affirming care so that lawmakers and judges do not make decisions on such care without

The Philosophical Fiction of Substituted Judgment.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Associations of Physician Perspectives, Personal Choices, and Counseling for Severe Congenital Heart Defects.

Woo JL, et al.

OBJECTIVE: To assess whether physicians' perspectives of outcomes or personal choices are associated with prenatal counseling for termination of pregnancy (TOP) or perinatal hospice for severe congenital heart defects (CHDs). METHOD:…

IVF, Culture Wars, and "Joy"

How did in vitro fertilization (IVF) transform itself in the public mind from a morally disreputable practice to an essential medical service? In the early days of IVF research, it was stridently condemned by religious leaders, famous scien

Research in Gender Medicine Sucks

	Since 2017, the number of patients diagnosed with gender dysphoria (GD) nearly tripled, the average age of patients receiving this diagnosis fell from 31 to 26, and the diagnosis of GD has become much more common among women than men.

Imane Khalif and Eero Mäntyranta

The controversy over Algerian boxer Imane Khalif couldn’t help but remind me of the great Finnish Nordic skier, Eero Mäntyranta. Mäntyranta dominated the sport. Between 1960 and 1972, he won 7 medals and 3 golds. He was so extraordinary th

Whistleblowing: A Special Sort of Hell

Dear reader, I have become sort of obsessed with Carl Elliott’s new book. In it, he writes of his own experiences as a medical whistleblower about perceived research misconduct at the University of Minnesota. That part of the book is deeply

Is Comstock Coming for your Condoms?

When I was fifteen, there were only two options for buying condoms. They were available from vending machines in the men’s rooms of some seedy restaurants. There, they came in fruit flavors, had names like “French tickler,” and promised “to

Shortcomings of Citizen Science

Amy Dockser Marcus argues that the way we do science has changed. As evidence, she tells the story of how parents of children with a rare disease - Neimann-Pick Type C, or NPC – became partners with drug companies and NIH scientists in desi

Gaza and the complexity and context of suffering.

Zivot JB, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Gaza and the complexity and context of suffering

Joel Zivot, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The slow, necessary growth of pediatric palliative care.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Abortion as a human right’

Controversy over the legality of abortion is heated throughout the world. The United States is one of the few countries in the world that has restricted abortion rights recently. In this article, I will review the controversy over abortion…

How to move forward in shared decision-making in pediatric palliative care

Chantal Y. Joren, et al.

Pediatric palliative care has grown immensely in recent years in the world. However, shared decision-making remains a complex process, especially in pediatric palliative care. In particular, a number of issues are priorities to improve the…

How Will Medicare Negotiate Drug Prices, And What Impact Will It Have?

Marc A. Rodwin

A new law allowing Medicare to negotiate drug prices makes Medicare similar to other countries' national health authorities and may help control drug prices in the US. However, some features of the law allow manufacturers to retain…

The slow, necessary growth of pediatric palliative care

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Dutch model for regulating paediatric euthanasia

Eduard Verhagen

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Texas Abortion Decision

Sorry for the glitch on my last post. I'm working on it. My thoughts on the Texas Supreme Court decision can be read here:https://www.thehastingscenter.org/texas-supreme-court-offers-roadmap-for-legal-abortion/The decision is trying to in

Suppressing free speech as a form of free speech?

Censorship is on the rise across America. With censorship, questions always arise about who gets censored, who gets to do the censoring, and by what standards. Questions also arise about the goals of censorship since we know that censoring

I dare you: Read these two books together.

A few weeks ago, I wrote about turmoil in pediatric gender medicine. Nobody, not even leaders of the field, can explain the rapid rise in the prevalence of gender dysphoria. There are plenty of different theories about why GD is occurring

Gender-affirming treatment: life-saver or child-abuse

By any account, the field of pediatric gender medicine is a mess. Even experts in the field cannot agree about what is going on, where the field is going, or where it ought to go. In politics, the controversies are even worse. At least 20

Who should debate RFK Jr?

Robert F. Kennedy Jr. thinks vaccines kill children and cause brain damage. He thinks they continue to be given only because of a massive conspiracy between Big Pharma, scientists, and governments throughout the world. He ignores the benefi

Drama about Duchenne at the FDA

The recent meeting of an FDA Advisory Committee charged with making a recommendation about an innovative gene therapy for the treatment of Duchenne Muscular Dystrophy was surprisingly dramatic. It was, in fact, so highly scripted that coul

Is Pregnancy A Disease?

Philosopher Dan Brudney explored the implications the simple statement that pregnancy is not a disease. The paper is particularly relevant because similar arguments crop up in the current controversy about abortion pills. Brudney was fight

Trans politics brings down PM Sturgeon

Scottish Prime Minister Nicola Sturgeon says that she resigned because she was exhausted by the pandemic. Others think that the battle over gender politics contributed to her decision to step down. But the pandemic is over. And the batt

Understanding the Clinical Utility of Genome Sequencing in Critically Ill Newborns.

Brunelli L, Hayeems RZ

Diagnostic genome sequencing (GS) in newborns may have many benefits. More accurate diagnosis could spur the development of innovative genomic therapies. A precise diagnosis could help doctors and parents anticipate clinical problems and…

Challenges in accelerated approvals for gene therapies

Rafael Escandon

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Pediatric palliative care across continents: Communication and shared-decision-making

Chantal Y. Joren, et al.

Despite the significant growth and development of pediatric palliative care worldwide, significant challenges remain. One of those challenges is shared decision-making, by which parents, families and professionals all work together to…

Reply to Letter about whole genome sequencing in newborns

Annie Janvier, Keith J. Barrington

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Dilemmas of Artificial Wombs: Conventional Ethics and Science Fiction

Annie Janvier

Click to increase image sizeClick to decrease image sizeThis article refers to:Ethics Considerations Regarding Artificial Womb Technology for the Fetonate Additional informationFundingThe author(s) reported there is no funding associated…

The FDA’s Dueling Narratives: Protector Versus Obstacle

Marc A. Rodwin

The traditional narrative portrays the Food and Drug Administration as the protector of patients from drugs that have not been proven safe and effective. Recently, a different narrative has arisen that sees the agency as an obstacle to…

The Dilemmas of Artificial Wombs: Conventional Ethics and Science Fiction.

Janvier A

Click to increase image sizeClick to decrease image sizeThis article refers to:Ethics Considerations Regarding Artificial Womb Technology for the Fetonate Additional informationFundingThe author(s) reported there is no funding associated…

Understanding the Clinical Utility of Genome Sequencing in Critically Ill Newborns

Luca Brunelli, Robin Z. Hayeems

Diagnostic genome sequencing (GS) in newborns may have many benefits. More accurate diagnosis could spur the development of innovative genomic therapies. A precise diagnosis could help doctors and parents anticipate clinical problems and…

A humane society after Dobbs?

O. Carter Snead’s book, What it Means to Be Human, is really two books. One is an idealistic program for cultural renewal. The other is a diatribe against a philosophy that he calls “expressive individualism.” Both are presented as a criti

Caution about COVID vaccines for kids

Five separable but interrelated issues should inform policies about COVID vaccines for kids. First, what is the goal? Vaccine doesn’t prevent infection but it decreases the likelihood of severe disease. So any measure of efficacy must loo

Nights of Plague and Lessons of History

	Orhan Pamuk’s novel Nights of Plague feels ripped from the headlines. A deadly infectious disease that started in China is threatening the world. Leaders first deny the threat, then harness fear and confusion to expand their authorita

UK Appeals Court Supports Ableism

Ms. Heidi Crowter has Down Syndrome. So does her son Aiden. She thinks that her and her son’s lives are are worth living. She thinks that the current British law governing abortion devalues her life in a way that causes her harm. She su

The SARS-CoV-2 Lab-Leak Theory and the Dog That Did Not Bark

In a Sherlock Holmes story, a racehorse disappears on the night before a big race. Holmes is called in to investigate. He focuses not on the evidence that was collected but, instead, on a bit of key evidence that is missing. A dog that s

Converging Crises for Kids

Two ominous trends, and two ends of the illness severity spectrum, portend trouble for kids who need health care and the doctors who take care of them.The first one is that kids are healthier than they have ever been. Many kids used to die

COVID, Colonoscopies, and Certainty

OK, just “follow the science.” What the hell does that mean? Philosophers of science know that scientific knowledge is value-laden. We decide what to study, how to study it, and then how to analyze results and draw inferences based on our

What matters with Kansas

Sedgewick County, home of Wichita, voted 58-42 to preserve abortion rights. That says it all. The organized anti-abortion movement started in a football stadium at Wichita State University in the summer of 1991. More than 25,000 anti-abor

Three really good bioethics books

While giving birth to her second child, Josephine, Dr. Jane Lee has a uterine rupture. It was misdiagnosed. Her baby went without oxygen for a long time and suffered significant brain damage. Her book, Catastrophic Rupture, A Memoir of He

So? Gonna immunize your kids?

Parents in the US make up their own minds about immunizations. Almost all consent to some vaccines for their kids. Over 99% of US children have received at least one dose of one vaccine. But immunization rates vary for different vaccines.

Conscience claims after Roe v. Wade

Fifteen years ago, we reported that 16% of doctors in the United States would neither discuss abortion with patients nor refer their patients for one. We defended the right of these doctors to practice according to their conscientiously he

The reality of compulsory pregnancy

Annie Ernaux describes her abortion like this, “I could see the tiles between my thighs. I pushed with all my strength. It burst forth like a grenade, in a spray of water that splashed the door. I saw a baby doll dangling from my loins at

Making football safe for prayer

There are some serious theological questions here. What sort of God would desire prayers offered on the fifty yard line immediately after a football game? What sort of judge would consider such prayers to be personal and private?The majo

Helping Students Cheat

I just had a really weird experience. I was searching for my 2016 essay about Henrietta Lacks. To critique Rebecca Skloot’s book about Ms. Lacks and her family, Skloot’s book is commonly assigned on college campuses today. I draw on Wall

COVID Orphans: The Hidden Pandemic

Children are less likely than adults to die of COVID-19. But over 200,000 children in the United States have lost a home caregiver – a parent or grandparent – to COVID. Around the world, millions of children have been orphaned. Orphanhood

Good science without pain

		Are there ever situations in which a painful sham procedure can be done (with analgesia) in order to increase the scientific rigour of the study?	Babies in neonatal intensive care units undergo many painful procedures.&#009

School shootings and political will

Americans love their guns. They vote based on that passion. Politicians follow the votes. A recent Pew poll shows a deeply divided country.About half see gun violence as a big problem. Half don’t. The percentage of American who favor stric

Thirteen Ways of Looking at Henrietta Lacks

	Wallace Stevens wrote “Thirteen Ways of Looking at a Blackbird” to suggest that what we see is never simply what is there. Seeing always requires imagination. I’ve tried to imagine thirteen ways of looking at Henrietta Lacks. 	

The Moral Cost of Methodologic Rigor

What sort of sicko would want to give a critically ill baby a useless and painful shot? Only a sadist! Or a scientist! The history of research ethics is full of stories about scientists causing harm because their moral sensibilities wer

Let's talk about gender identity

I'll admit it: I am afraid to write about gender. I'm sure to say the wrong things. I'll say "gender dysphoria" when I should say "gender incongruence" or "disorder" when I should say "difference."

Current controversies in neonatal resuscitation

Becky Ennis, Danielle Jw Reed

The goal of neonatal bioethics is to help clinicians navigate difficult decisions that arise every day in the care of critically ill newborns. Over the last few decades, there have been vigorous discussions of numerous ethical issues. For…

Current controversies in neonatal resuscitation.

Ennis BJ, Reed DJ

The goal of neonatal bioethics is to help clinicians navigate difficult decisions that arise every day in the care of critically ill newborns. Over the last few decades, there have been vigorous discussions of numerous ethical issues. For…

Disposition Decisions in Cases of Medical Complexity and Health Inequity

Joseph P. Shapiro, et al.

The question of optimal disposition for children with complex medical and social circumstances has long challenged the well-intentioned clinician. The coronavirus disease 2019 pandemic created unique difficulties for patients, families,…

The moral risk of methodological purity.

Babies feel pain.1 A baby's painful experiences can have long-term psychological effects.2 We have effective methods to relieve pain. It is morally imperative that we use them to reduce babies' pain and suffering as much as safely…

Ethical and epistemic issues in the design and conduct of pragmatic stepped-wedge cluster randomized clinical trials

Carole A. Federico, et al.

Stepped-wedge cluster randomized trial (SW-CRT) designs are increasingly employed in pragmatic research; they differ from traditional parallel cluster randomized trials in which an intervention is delivered to a subset of clusters, but not…

Fetal Therapies and Clinical Research: Beyond Risk and Benefit

Lesha D. Shah, et al.

This article refers to:A New Ethical Framework for Assessing the Unique Challenges of Fetal Therapy TrialsConsidering Reprogenomics in the Ethical Future of Fetal Therapy TrialsConsents (and Contents) Under Pressure: Maintaining Space for…

The moral risk of methodological purity

Babies feel pain.1 A baby's painful experiences can have long-term psychological effects.2 We have effective methods to relieve pain. It is morally imperative that we use them to reduce babies' pain and suffering as much as safely…

Suicide Risk in Adolescents During the COVID-19 Pandemic.

et al.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic created high levels of psychological distress and may have increased suicide risk. METHODS: We used the 4-item Ask Suicide-Screening Questions (ASQ) to assess suicide risk among…

Ethics of care for the micropreemies. Just because we can, should we?

Debates about treatment for the tiniest premature babies focus on three different approaches - universal non-resuscitation, selective resuscitation, and universal resuscitation. Doctors, hospitals, and professional societies differ on…

Disposition Decisions in Cases of Medical Complexity and Health Inequity.

Shapiro JP, et al.

The question of optimal disposition for children with complex medical and social circumstances has long challenged the well-intentioned clinician. The coronavirus disease 2019 pandemic created unique difficulties for patients, families,…

Ethical and scientific complexity in debates about <scp>COVID</scp> vaccination in children

Dominic Dominic, Annie Janvier

Decisions about COVID-19 immunisations for children must consider five interrelated issues. First, one must clarify the goals of immunisation. Is it to prevent infection, severe infection, hospitalisation or mortality for the immunised…

Should We Aspire to Be Rational About Letting Babies Die?

Click to increase image sizeClick to decrease image sizeThis article is referred to by:Postponed Withholding: An Ethical Tool for Health Care Personnel to Empower ParentsThis article refers to:Postponed Withholding: Balanced…

Next generation sequencing in neonatology: what does it mean for the next generation?

Annie Janvier, Keith J. Barrington

Rapid whole genome sequencing (WGS) and whole exome sequencing (WES), sometimes referred to as "next generation sequencing" (NGS) are now recommended by some experts as a first-line diagnostic test to diagnose infants with suspected…

Ethics knowledge, attitudes, and experiences of tertiary care pediatricians in Ethiopia.

Tekleab AM

BACKGROUND: Pediatricians in developing countries face different ethical dilemmas than do doctors working in settings with more resources. There are very few studies from developing countries analyzing pediatricians' knowledge and…

Ethics knowledge, attitudes, and experiences of tertiary care pediatricians in Ethiopia

Atnafu Mekonnen Tekleab

BACKGROUND: Pediatricians in developing countries face different ethical dilemmas than do doctors working in settings with more resources. There are very few studies from developing countries analyzing pediatricians' knowledge and…

17 First Attempt

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Promoting COVID-19 Vaccination on Social Media

Fajar Raza

People’s willingness to get immunized against coronavirus disease 2019 (COVID-19) continues to shift.1 Vaccine hesitancy remains high in minority communities.2 We do not know how parents will respond when the vaccine becomes available for…

Index

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

7 What Are the Risks?

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Balancing risks and benefits of open notes for neonatology.

Lou LJ, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Endgame

Martha Gershun

This chapter begins with detailing the author's final results following her three-day grueling tests for glucose tolerance, psychological screening, kidney function, EKG, and a chest X-ray. The author found out that there was an issue with…

Frontmatter

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Effect of COVID-19 on the Detection and Prevalence of Suicidality in Adolescents

et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

18 Second Attempt

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A Look Back at Bioethics: William L. Meadow, 1948–2019

William L. Meadow, MD, PhD, died at the age of 70 years on Saturday, September 14, 2019. Meadow was a consummate neonatologist, a devoted teacher, a great soccer coach, an accomplished a cappella singer, and an iconoclastic bioethicist. He…

Sources of Unease About the Use of Genome Sequencing for Diagnosing Rare Diseases in Children

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Lessons From the Pandemic: How a Children’s Hospital Responded to the Challenges of COVID-19

et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Reply

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Sources of Unease About the Use of Genome Sequencing for Diagnosing Rare Diseases in Children.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethical issues in treatment of babies born at 22 weeks of gestation

Many centres now report that more than half of babies born at 22 weeks survive and most survivors are neurocognitively intact. Still, many centres do not offer life-sustaining treatment to babies born this prematurely. Arguments for not…

Shared Decision Making, Truth Telling, and the Recalcitrant Family

Discussions between pediatricians and parents about withholding or withdrawing life-sustaining treatment are emotionally difficult. There is uncertainty on both sides. Doctors are often making a probabilistic assessment of the chances that…

The Arcane Process of Screening Living Donors

Martha Gershun

This chapter focuses on the careful medical and psychosocial screening that is required for living donors. It analyzes the motivations of family donors, voluntariness, and the possibility of intrafamilial coercion. In the early days of…

Dear President Biden: We Need a Truth and Reconciliation Commission.

“Old Black Joe still picking cotton for your ribbons and bows.And everybody knows.”- Leonard Cohen, “Everybody Knows.”African-Americans and other minorities are suffering disproportionately during

What Are the Risks?

Martha Gershun

This chapter examines the risks, both surgical and medical, to donating a kidney. It reviews the financial ramifications of donating a kidney and the nonmedical risks of living with only one kidney — organ damage from contact sports. The…

Dear President Biden: We Need a Truth and Reconciliation Commission

“Old Black Joe still picking cotton for your ribbons and bows.And everybody knows.”- Leonard Cohen, “Everybody Knows.”African-Americans and other minorities are suffering disproportionately during

Evaluation at Mayo

Martha Gershun

This chapter begins with narrating the author's preparation for the required tests and evaluations at the Mayo Clinic. It reviews the two purposes of the tests and consultations: they were designed to ensure that donating an organ would…

19 Follow-Up

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Going Public, Moving Forward

Martha Gershun

This chapter looks at how the author and Deb Porter Gill decided to go public on social media about their match. The chapter narrates the people's reactions upon hearing their story, most either thought the author was a living saint or a…

Resources

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

9 The Endgame

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A Look Back at Bioethics: William L. Meadow, 1948-2019.

William L. Meadow, MD, PhD, died at the age of 70 years on Saturday, September 14, 2019. Meadow was a consummate neonatologist, a devoted teacher, a great soccer coach, an accomplished a cappella singer, and an iconoclastic bioethicist. He…

Implementing Universal Suicide Risk Screening in a Pediatric Hospital

Shayla A. Sullivant, et al.

BACKGROUND: Health care providers are in a prime position to identify teens at risk for suicide, yet many do not. The research team developed and implemented a hospitalwide program to identify teens at elevated risk for suicide and connect…

Meeting “My” Recipient

Martha Gershun

This chapter talks about the process of medical tests, information sessions, and psychological evaluations after Deb Porter Gill and the author matched with on all six HLA tissue type markers. The chapter displays the author's excitement…

The Countdown Begins

Martha Gershun

This chapter begins with Deb Porter Gill and the author's discussion about directed donation after their chain in the paired exchange called off. The chapter then displays Deb's frustrations with the Mayo Clinic's lack of communication and…

The Odyssey Continues

Martha Gershun

This chapter chronicles the author's narrative following her new hypertension medication routine until her blood pressure met Mayo standards. It details the costs, the hassles, and the barriers to donating a kidney that the author…

Do I Own My Organs?

Martha Gershun

This chapter evaluates the author's narrative after her meeting with Deb Porter Gill. It offers a variety of outcomes if the author had not liked Deb and withdrawn the offer to donate. That could have been for any reason, including…

The Main Challenges in Pediatric Ethics from Around the Globe

Nico Nortjé, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Reply.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethical issues in treatment of babies born at 22 weeks of gestation.

Many centres now report that more than half of babies born at 22 weeks survive and most survivors are neurocognitively intact. Still, many centres do not offer life-sustaining treatment to babies born this prematurely. Arguments for not…

Grappling With Racial Health Inequity in Pediatric Cardiology

Bianca Cherestal, Tamorah Lewis

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Rates of Positive Suicide Screens among the Emergency, Inpatient and Outpatient Clinics at a Tertiary Care Children’s Hospital

Fajar Raza, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

6 Are “Stranger Donors” Irrational?

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Unnecessary Bureaucratic Barriers or Appropriate Patient Protection?

Martha Gershun

This chapter asserts that transplant centers have very strong motivations to encourage people to become living kidney donors. It analyzes the average age of transplant recipients today, the surgical and postsurgical complications when an…

Lessons Learned

Martha Gershun

This chapter talks about the key lessons following the author's story. It argues that kidney donors are not patients in the traditional sense of that word, and should perhaps think of them as philanthropists who donate a body part instead…

Exploration and Ethical Analysis of Open-label Pediatric Vaccine Trials in a Pandemic

Ian Wolfe, et al.

Young children will ultimately need to be vaccinated to stop the spread of coronavirus disease 2019 (COVID-19). Initial studies of vaccine were performed in adults. Randomized controlled trials are the gold standard. In the COVID-19…

Grappling With Racial Health Inequity in Pediatric Cardiology.

Cherestal B, Lewis T

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Are “Stranger Donors” Irrational?

Martha Gershun

This chapter seeks to understand the motivations of people who offered to donate a kidney to a stranger. It explores the degree of emotional relationship that was essential to justify the claim that donation provided a psychological…

Promoting COVID-19 Vaccination on Social Media.

Raza F

People’s willingness to get immunized against coronavirus disease 2019 (COVID-19) continues to shift.1 Vaccine hesitancy remains high in minority communities.2 We do not know how parents will respond when the vaccine becomes available for…

Introduction

Shared decision making between doctors and patients has become the norm in medical decision making. There are three good reasons why there has been a shift from the traditional paternalistic model to a more bilateral and patient-centered…

Balancing risks and benefits of open notes for neonatology

Lily J. Lou, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

First Attempt

Martha Gershun

This chapter begins with detailing the author's travel to Rochester for the upcoming surgery and the final pre-op tests. The chapter recounts the experience the author went through from the rigorous process and evaluation of managing the…

8 Unnecessary Bureaucratic Barriers or Appropriate Patient Protection?

Martha Gershun

This chapter asserts that transplant centers have very strong motivations to encourage people to become living kidney donors. It analyzes the average age of transplant recipients today, the surgical and postsurgical complications when an…

Staying Healthy

Martha Gershun

This chapter focuses on the author's set of self-imposed restrictions to be healthy in preparation for the surgery date. The chapter tells how the author managed to attend the synagogue's Rosh Hashanah services, where hundreds of people…

20 Lessons Learned

Martha Gershun

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Second Attempt

Martha Gershun

This chapter focuses on Deb Porter Gill's second surgery attempt after the first postponed kidney transplant. It details the entire list of surgical risks again and the need for a new signature on the consent forms. The chapter also…

Should teens be allowed to consent for vaccines?

Teens and children will need to be vaccinated in order to achieve herd immunity against COVID-19. Most parents are eager to have their teens immunized, whereas some are hesitant. Should teens be allowed to consent to immunization even if…

Why Not Me?

Martha Gershun

This chapter discusses a system for screening living donors. The chapter begins with a narrative of the author as she was anxiously waiting to hear whether the Transplant Selection Committee at the Mayo Clinic in Rochester, Minnesota, was…

Epilogue

Martha Gershun

This chapter looks at Deb Porter Gill's and the author's lives nearly two years since transplant operation. Both women continue to enjoy good health, with no significant complications from the procedure. It describes Deb's vigilant regimen…

Exploration and Ethical Analysis of Open-label Pediatric Vaccine Trials in a Pandemic.

Wolfe ID, et al.

Young children will ultimately need to be vaccinated to stop the spread of coronavirus disease 2019 (COVID-19). Initial studies of vaccine were performed in adults. Randomized controlled trials are the gold standard. In the COVID-19…

Follow-Up

Martha Gershun

This chapter focuses on Deb Porter Gill's and the author's completion of the post-op evaluation, five months after the surgery at the Mayo Clinic. It describes the recovery stories of both women and their trip for Mayo's final testing. The…

Don't Blame Hippocrates for Low Enrollment in Clinical Trials.

This article refers to:Self-Defeating Codes of Medical Ethics and How to Fix Them: Failures in COVID-19 Response and

Parents Demand and Teenager Refuses Epidural Anesthesia

Ivor Berkowitz, et al.

A 15-year-old girl is scheduled to undergo an upper lobectomy to debulk metastatic Ewing sarcoma. The anesthesiologist recommended placement of a thoracic epidural catheter to provide postoperative analgesia. The patient did not want a…

Medicaid Expansion and Childhood Cancer Care

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Randomized Trials are Deeply Offensive

In this issue, Macklin and Natanson examine some of the controversies that arise in randomized clinical trials (RCTs). They are particularly concerned that researchers may misrepresent novel

Controversy About Withdrawal of Postresuscitation Care After Cardiac Arrest.

Gardner KJ, et al.

With increasing focus in the last decade on post–cardiac arrest care in pediatrics, return of spontaneous circulation, survival rates, and neurologic outcome have improved. As part of this postarrest care, both the American Heart…

Parental Concerns on Short Stature: A 15-Year Follow-Up.

Murano MC, Feldt MM

OBJECTIVES: To compare parental attitudes about short stature over time and determine possible factors that predict changes in attitudes. STUDY DESIGN: At baseline (1993-1994), we surveyed parents about their attitudes regarding their…

"Take Out This Thing": A Teen's Decision About Removal of a Gastrostomy Tube.

Gutiérrez HM, et al.

Medical decision-making in children is not a static process. In pediatrics, parents and health professionals actively participate in clinical decision-making. They always consider what is in the child's best interest and sometimes weigh…

Medicaid Expansion and Childhood Cancer Care: What Effects Has It Had?

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Should Pediatric Patients Be Prioritized When Rationing Life-Saving Treatments During COVID-19 Pandemic

Ryan M. Antiel, et al.

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced…

Children's Hospital ICU Resource Allocation in an Adult Pandemic.

Wolfe ID, et al.

Imagine the following situation: A 25-year-old is intubated in the emergency department for coronavirus disease 2019 (COVID-19)–related acute respiratory distress syndrome. The adult ICU is full. The nearby PICU has many available beds and…

Randomized Trials are Deeply Offensive.

In this issue, Macklin and Natanson examine some of the controversies that arise in randomized clinical trials (RCTs). They are particularly concerned that researchers may misrepresent novel

Paediatric ethical issues during the COVID‐19 pandemic are not just about ventilator triage

Marlyse F. Haward, et al.

Administrators and providers worry about an overwhelming shortage in critical life-saving ventilators for adults during the COVID-19 pandemic. Attention has focused on developing algorithms for ventilator allocation using several factors,…

Seeking Normalcy as the Curve Flattens: Ethical Considerations for Pediatricians Managing Collateral Damage of Coronavirus Disease-2019

Dalia M. Feltman, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Access to Transplantation for Undocumented Pediatric Patients

Olga Charnaya, et al.

Clinicians in the United States today regularly face dilemmas about health disparities. Many patients and families cannot afford the medical care that doctors recommend. These problems are most stark when the medical care that is needed is…

Lessons learned from the COVID‐19 pandemic

Erwin Jiayuan Khoo

The authors have no conflict of interest to

COVID-19 Trial Enrollment for Those Who Cannot Consent: Ethical Challenges Posed by a Pandemic

Samantha A. House, et al.

The current coronavirus disease 2019 (COVID-19) pandemic has triggered an intense global research effort to inform the life-saving work of frontline clinicians who need reliable information as soon as possible. Yet research done in…

Parental Concerns on Short Stature: A 15-Year Follow-Up

Maria Cristina Murano, Matthew M. Feldt

OBJECTIVES: To compare parental attitudes about short stature over time and determine possible factors that predict changes in attitudes. STUDY DESIGN: At baseline (1993-1994), we surveyed parents about their attitudes regarding their…

Lessons learned from the COVID-19 pandemic.

Khoo EJ

The authors have no conflict of interest to

Long-term Puberty Suppression for a Nonbinary Teenager.

Pang KC, et al.

Many transgender and gender-diverse people have a gender identity that does not conform to the binary categories of male or female; they have a nonbinary gender. Some nonbinary individuals are most comfortable with an androgynous gender…

When a Family Seeks to Exclude Residents From Their Child's Care.

Largent EA, et al.

A primary goal of our medical education system is to produce physicians qualified to promote health, prevent and treat disease, and relieve suffering. Although some aspects of the practice of medicine can be learned in classrooms, from…

The Pediatrician’s Role in Evaluating Teens Who Might Have Been Radicalized

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Pediatric Cardiology Specialist’s Opinions Toward the Acceptability of Comfort Care for Congenital Heart Disease

Tara Swanson, et al.

In order to evaluate physicians' willingness to seek legal action to mandate surgery when parents refuse surgery for various congenital heart lesions, we surveyed pediatric cardiologists and cardiovascular surgeons at 4 children's…

Author Response.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When a Family Seeks to Exclude Residents From Their Child’s Care

Emily A. Largent, et al.

A primary goal of our medical education system is to produce physicians qualified to promote health, prevent and treat disease, and relieve suffering. Although some aspects of the practice of medicine can be learned in classrooms, from…

Long-term Puberty Suppression for a Nonbinary Teenager

Ken C. Pang, et al.

Many transgender and gender-diverse people have a gender identity that does not conform to the binary categories of male or female; they have a nonbinary gender. Some nonbinary individuals are most comfortable with an androgynous gender…

Parents Demand and Teenager Refuses Epidural Anesthesia.

Berkowitz I, et al.

A 15-year-old girl is scheduled to undergo an upper lobectomy to debulk metastatic Ewing sarcoma. The anesthesiologist recommended placement of a thoracic epidural catheter to provide postoperative analgesia. The patient did not want a…

Yes to Life: An Opportunity for Partnership Between Medicine and Religion.

Pope Francis recently spoke about perinatal palliative care and the dilemmas that parents of critically ill babies encounter. In his speech, the Pope beautifully captured what many parents feel. They love their baby even if they know that…

Pediatric Cardiology Specialist's Opinions Toward the Acceptability of Comfort Care for Congenital Heart Disease.

Swanson TM, et al.

In order to evaluate physicians' willingness to seek legal action to mandate surgery when parents refuse surgery for various congenital heart lesions, we surveyed pediatric cardiologists and cardiovascular surgeons at 4 children's…

Our Next Pandemic Ethics Challenge? Allocating “Normal” Health Care Services

Jeremy R. Garrett, et al.

The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our…

The Belmont Report and Innovative Clinical Research.

A central pillar of the Belmont Report is that a bright line must be drawn between medical practice and biomedical research. That line may have been brighter 50 years ago. Today, the typical physician is likely to work for a corporation or…

Our suffering and the suffering of our time

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Author Response

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Medically Vulnerable Clinicians and Unnecessary Risk During the COVID-19 Pandemic.

Janvier A

Jason is 68 years old. He is a retired family doctor who lives in Vermont. He worked in the emergency room, made home visits to complex patients and was responsible for organizing the home visit

The Belmont Report and Innovative Clinical Research

A central pillar of the Belmont Report is that a bright line must be drawn between medical practice and biomedical research. That line may have been brighter 50 years ago. Today, the typical physician is likely to work for a corporation or…

Children’s Hospital ICU Resource Allocation in an Adult Pandemic

Ian Wolfe, et al.

Imagine the following situation: A 25-year-old is intubated in the emergency department for coronavirus disease 2019 (COVID-19)–related acute respiratory distress syndrome. The adult ICU is full. The nearby PICU has many available beds and…

Should Pediatric Patients Be Prioritized When Rationing Life-Saving Treatments During COVID-19 Pandemic.

Antiel RM, et al.

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced…

Don’t Blame Hippocrates for Low Enrollment in Clinical Trials

This article refers to:Self-Defeating Codes of Medical Ethics and How to Fix Them: Failures in COVID-19 Response and

Healthcare organizations and high profile disagreements.

Moore B

In this paper, we examine healthcare organizations' responses to high profile cases of doctor-parent disagreement. We argue that, once a conflict crosses a certain threshold of public interest, the stakes of the disagreement change in…

All for One and One Delivery Room Approach for All?

Autumn Kiefer, et al.

Multiple births are increasing in frequency related to advanced maternal age and fertility treatments, and they have an increased risk for congenital anomalies compared to singleton births. However, twins have the same congenital anomalies…

Controversy About Withdrawal of Postresuscitation Care After Cardiac Arrest

Kelly Gardner, et al.

With increasing focus in the last decade on post–cardiac arrest care in pediatrics, return of spontaneous circulation, survival rates, and neurologic outcome have improved. As part of this postarrest care, both the American Heart…

Our suffering and the suffering of our time.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Our Next Pandemic Ethics Challenge? Allocating "Normal" Health Care Services.

Garrett JR, et al.

The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our…

Pediatric Palliative Care in a Pandemic: Role Obligations, Moral Distress, and the Care You Can Give

Amanda Evans, Monique Jonas

Many ethical issues arise concerning the care of critically ill and dying patients during the coronavirus disease 2019 (COVID-19) pandemic. In this issue's Ethics Rounds, we present 2 cases that highlight 2 different sorts of ethical…

Access to Transplantation for Undocumented Pediatric Patients.

Charnaya O, et al.

Clinicians in the United States today regularly face dilemmas about health disparities. Many patients and families cannot afford the medical care that doctors recommend. These problems are most stark when the medical care that is needed is…

Medically Vulnerable Clinicians and Unnecessary Risk During the COVID-19 Pandemic

Annie Janvier

Jason is 68 years old. He is a retired family doctor who lives in Vermont. He worked in the emergency room, made home visits to complex patients and was responsible for organizing the home visit

Benefits and Risks of Visitor Restrictions for Hospitalized Children During the COVID Pandemic

Alice Virani, et al.

To control the spread of severe acute respiratory syndrome coronavirus 2, the virus responsible for coronavirus disease 2019, many hospitals have strict visitor restriction policies. These policies often prohibit both parents from visiting…

Benefits and Risks of Visitor Restrictions for Hospitalized Children During the COVID Pandemic.

Virani AK, et al.

To control the spread of severe acute respiratory syndrome coronavirus 2, the virus responsible for coronavirus disease 2019, many hospitals have strict visitor restriction policies. These policies often prohibit both parents from visiting…

Yes to Life: An Opportunity for Partnership Between Medicine and Religion

Pope Francis recently spoke about perinatal palliative care and the dilemmas that parents of critically ill babies encounter. In his speech, the Pope beautifully captured what many parents feel. They love their baby even if they know that…

“Take Out This Thing”: A Teen’s Decision About Removal of a Gastrostomy Tube

Hazel Gutiérrez, et al.

Medical decision-making in children is not a static process. In pediatrics, parents and health professionals actively participate in clinical decision-making. They always consider what is in the child's best interest and sometimes weigh…

Seeking a Second Opinion on Social Media.

Caruso Brown AE, et al.

Social media pervades all aspects of our lives. In medicine, it has changed the ways that patients and parents get health information, advocate for particular treatments for themselves and their children, and raise money for expensive…

Affirming, Balanced, and Comprehensive Care for Transgender Teenagers.

Leibowitz SF

The last decade has seen a substantial shift regarding psychological and medical approaches to children and adolescents seeking care for gender dysphoria. Gender identity is now recognized as existing along a spectrum rather then as…

Ethics Rounds: Long-term puberty suppression for a non-binary teen

Kky Pang, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Hopes, Fears, and Deja Vu Regarding Germline Gene Editing

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Ethical and Psychosocial Issues in Whole Genome Sequencing (WGS) for Newborns

In this article, I review some of the ethical issues that have arisen in the past when genetic testing has been done in newborns. I then suggest how whole genome sequencing may raise a new set of issues. Finally, I introduce a series of…

Ethical and Psychosocial Issues in Whole Genome Sequencing (WGS) for Newborns.

In this article, I review some of the ethical issues that have arisen in the past when genetic testing has been done in newborns. I then suggest how whole genome sequencing may raise a new set of issues. Finally, I introduce a series of…

Considerations to Guide Treatment Decisions for Infants Born Weighing Less Than 400 g

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

The Potential Benefits of Research May Justify Certain Research Risks.

Wendler D, Nelson RM

US regulations allow institutional review boards to approve pediatric clinical trials only when the risks are minimal or (in some cases) a minor increase over minimal, or when the risks are justified by a potential for direct benefit to…

Bioethics in the Pediatric ICU: Ethical Dilemmas Encountered in the Care of Critically Ill Children

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When Parents Take Conflicts to Digital Media

Bryanna Moore

Over the past decade, there have been numerous cases around the world in which parents have used digital media to orchestrate public opposition to doctors' recommendations. Parents are not always "successful" with such efforts; these cases…

Affirming, Balanced, and Comprehensive Care for Transgender Teenagers

Scott Leibowitz

The last decade has seen a substantial shift regarding psychological and medical approaches to children and adolescents seeking care for gender dysphoria. Gender identity is now recognized as existing along a spectrum rather then as…

Conclusion

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

BACKGROUND: Paramedics make important and increasingly complex decisions at scene about patient care. Patient safety implications of influences on decision making in the pre-hospital setting were previously under-researched. Cutting edge…

The Historical Foundation of Pediatric Critical Care

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Disclosing adverse events and near misses to parents of neonates.

Carter BS

Critically ill newborns receiving intensive and complex care may be subject to medical errors and adverse events. Like most physicians, neonatologists do not feel comfortable disclosing their errors and may need assistance in learning how…

The False-negative Phenotype.

Ethical controversies may arise when genome sequencing reveals a genetic variant that is thought to be pathogenic, but the patient has no symptoms. This could be due to variable penetrance or expressivity. It could also result from a…

Allowing Adolescents to Weigh Benefits and Burdens of High-stakes Therapies

Kriti Puri, et al.

We present the case of a girl aged 17 years and 10 months who has a strong family history of long QT syndrome and genetic testing confirming the diagnosis of long QT syndrome in the patient also. She was initially medically treated with…

When Specialty Care Is Unavailable to Rural Families.

deSante-Bertkau JE, et al.

We present the case of a 2-year-old boy with epidermolysis bullosa and supraglottic stenosis whose parents refuse an elective tracheostomy because of the significant care the tracheostomy would require. The patient's family lives in a…

Pediatric neurosurgeons' views regarding prenatal surgery for myelomeningocele and the management of hydrocephalus: a national survey.

Riley JS, et al.

OBJECTIVE: The Management of Myelomeningocele Study (MOMS) compared prenatal with postnatal surgery for myelomeningocele (MMC). The present study sought to determine how MOMS influenced the clinical recommendations of pediatric…

Critical Care Resource Utilization

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethics and Medico-legal implications in delivery room emergencies

Jessica Brunkhorst

There is very little law-either case law or statutory law - that regulates delivery room decisions about resuscitation of critically ill newborns. Most of the case law that exists is decades old. Thus, physicians cannot look to the law for…

Moral Distress in the PICU

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When Only Family Is Available to Interpret

Jessica Turnbull, et al.

When caring for patients and families who do not speak English, medical interpreters are necessary. Sometimes, our patients' families speak languages or dialects for which no in-person or video or phone interpreter can be found. If a…

Differing Thresholds for Overriding Parental Refusals of Life-Sustaining Treatment

Hannah Gerdes

When should doctors seek protective custody to override a parent's refusal of potentially lifesaving treatment for their child? The answer to this question seemingly has different answers for different subspecialties of pediatrics. This…

Clinical Ethics in Pediatrics: An International Perspective

et al.

In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children’s hospitals have ethics committees but that those committees are rarely…

Disclosure of Misattributed Paternity.

Prero MY, et al.

One of the most common dilemmas faced by physicians and genetic counselors is the discovery of misattributed paternity. In this article, we present a case in which misattributed paternity was discovered as an incidental finding. Experts…

Rethinking the “open future” argument against predictive genetic testing of children

Jeremy R. Garrett, et al.

Professional consensus has traditionally discouraged predictive genetic testing when no childhood interventions can reduce future morbidity or mortality. However, advances in genome sequencing and accumulating evidence that children and…

Right-To-Try Legislation

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Considerations to Guide Treatment Decisions for Infants Born Weighing Less Than 400 g.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Epidemiology of Critical Illness in Children

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Difficulty with Determining Whether Someone is Dead

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Hopes, Fears, and Deja Vu Regarding Germline Gene Editing.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

When Deeply Held Personal Beliefs Conflict with Collective Societal Norms.

This essay analyzes the conflicts that arise between an individual's deeply held beliefs and the collective norms of society. Sometimes these conflicts are framed in religious terms. The author argues that such a framing is too narrow and…

Disclosing adverse events and near misses to parents of neonates

Brian S. Carter

Critically ill newborns receiving intensive and complex care may be subject to medical errors and adverse events. Like most physicians, neonatologists do not feel comfortable disclosing their errors and may need assistance in learning how…

Clinical Ethics in Pediatrics: An International Perspective.

et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When Deeply Held Personal Beliefs Conflict with Collective Societal Norms

This essay analyzes the conflicts that arise between an individual's deeply held beliefs and the collective norms of society. Sometimes these conflicts are framed in religious terms. The author argues that such a framing is too narrow and…

When Adolescent and Parents Disagree on Medical Plan, Who Gets to Decide?

Kali Hopkins, et al.

An adolescent with DMD wants a life-extending tracheostomy, whereas his parents do not want this for

Ethical issues with testing and treatment for Krabbe disease.

Ehmann P

Early-infantile Krabbe disease (EIKD) is an autosomal recessive, progressive, neurodegenerative disorder that usually leads to death in infancy. A study published in 2005 indicated that hematopoietic stem-cell transplantation (HSCT) was…

Preventing Self-Harm From Repeat Foreign-Body Ingestion

Christina Low Kapalu, et al.

Mental health disorders in adolescents present some of the most challenging of all ethical dilemmas. This is particularly true when they lead to self-injurious behavior that can only be prevented by either limiting the freedom of the…

Ethics and Medico-legal implications in delivery room emergencies.

Brunkhorst J

There is very little law-either case law or statutory law - that regulates delivery room decisions about resuscitation of critically ill newborns. Most of the case law that exists is decades old. Thus, physicians cannot look to the law for…

Failure to Provide Adequate Palliative Care May Be Medical Neglect.

Levy C, et al.

Doctors are required to notify Child Protective Services (CPS) if parents do not provide appropriate medical care for their children. But criteria for reporting medical neglect are vague. Which treatments properly fall within the realm of…

The Potential Benefits of Research May Justify Certain Research Risks

David Wendler, Robert M. Nelson

US regulations allow institutional review boards to approve pediatric clinical trials only when the risks are minimal or (in some cases) a minor increase over minimal, or when the risks are justified by a potential for direct benefit to…

Ethical issues with testing and treatment for Krabbe disease

Paul Ehmann

Early-infantile Krabbe disease (EIKD) is an autosomal recessive, progressive, neurodegenerative disorder that usually leads to death in infancy. A study published in 2005 indicated that hematopoietic stem-cell transplantation (HSCT) was…

Chronically Critically Ill with Technological Dependence

Laura Miller‐Smith, Ásdís Finnsdóttir Wagner

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The False-negative Phenotype

Ethical controversies may arise when genome sequencing reveals a genetic variant that is thought to be pathogenic, but the patient has no symptoms. This could be due to variable penetrance or expressivity. It could also result from a…

Rethinking the "open future" argument against predictive genetic testing of children.

Garrett JR, et al.

Professional consensus has traditionally discouraged predictive genetic testing when no childhood interventions can reduce future morbidity or mortality. However, advances in genome sequencing and accumulating evidence that children and…

Seeking a Second Opinion on Social Media

Amy E. Caruso Brown, et al.

Social media pervades all aspects of our lives. In medicine, it has changed the ways that patients and parents get health information, advocate for particular treatments for themselves and their children, and raise money for expensive…

Pediatric neurosurgeons’ views regarding prenatal surgery for myelomeningocele and the management of hydrocephalus: a national survey

John S. Riley, et al.

OBJECTIVE: The Management of Myelomeningocele Study (MOMS) compared prenatal with postnatal surgery for myelomeningocele (MMC). The present study sought to determine how MOMS influenced the clinical recommendations of pediatric…

Does It Matter if This Baby Is 22 or 23 Weeks?

Annie Janvier, et al.

A 530-g girl born at 22 weeks and 6 days' gestation (determined by an ultrasound at 11 weeks) was admitted to the NICU. Her mother had received prenatal steroids. At 12 hours of age, she was stable on low ventilator settings. Her blood…

Disclosure of Misattributed Paternity

Moshe Prero, et al.

One of the most common dilemmas faced by physicians and genetic counselors is the discovery of misattributed paternity. In this article, we present a case in which misattributed paternity was discovered as an incidental finding. Experts…

Healthcare organizations and high profile disagreements

Bryanna Moore

In this paper, we examine healthcare organizations' responses to high profile cases of doctor-parent disagreement. We argue that, once a conflict crosses a certain threshold of public interest, the stakes of the disagreement change in…

When Only Family Is Available to Interpret.

Turnbull J, et al.

When caring for patients and families who do not speak English, medical interpreters are necessary. Sometimes, our patients' families speak languages or dialects for which no in-person or video or phone interpreter can be found. If a…

When Parents Take Conflicts to Digital Media.

Moore B

Over the past decade, there have been numerous cases around the world in which parents have used digital media to orchestrate public opposition to doctors' recommendations. Parents are not always "successful" with such efforts; these cases…

When Specialty Care Is Unavailable to Rural Families

Jennifer E. deSante-Bertkau, et al.

We present the case of a 2-year-old boy with epidermolysis bullosa and supraglottic stenosis whose parents refuse an elective tracheostomy because of the significant care the tracheostomy would require. The patient's family lives in a…

Failure to Provide Adequate Palliative Care May Be Medical Neglect

Carly Levy, et al.

Doctors are required to notify Child Protective Services (CPS) if parents do not provide appropriate medical care for their children. But criteria for reporting medical neglect are vague. Which treatments properly fall within the realm of…

Parents Refusing Dialysis for a 3-Month-Old With Renal Failure.

Willig L, et al.

A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed…

Ethical Problems in Decision Making in the Neonatal ICU.

Technological advances have altered the boundary between viable and nonviable newborns and increased the need to consider quality of life in intervention decisions. An approach to decision making that accounts for the complexity of family…

Tell Parents the Truth, but Tell It Slant.

This article draws on fiction, poetry, and memoir to suggest that for many people, tragic choices are best dealt with not through explicit conversations that directly confront difficult truths but, instead, through indirect and ambiguous…

Tell Parents the Truth, but Tell It Slant

This article draws on fiction, poetry, and memoir to suggest that for many people, tragic choices are best dealt with not through explicit conversations that directly confront difficult truths but, instead, through indirect and ambiguous…

Fertility Preservation for a Transgender Teenager.

Nahata L, et al.

In this article, we discuss a case in which a 16-year-old birth-assigned male came out to her parents as transgender. She is referred to the gender management program at a large pediatric academic center to discuss hormone therapy. She was…

Child Abuse, Incarceration, and Decisions About Life-sustaining Treatment

Paul C. Mann, et al.

Most critical care interventions for children occur in the framework of a supportive environment with loving parents that are present at the bedside to help to guide medical interventions through shared decision-making. What happens,…

Best Interest, Harm, God's Will, Parental Discretion, or Utility.

The impassioned and well-reasoned essays in this edition of the journal all agree with two claims: (1) children have moral claims that should be protected and recognized, and (2) we need ongoing

Unilateral Withdrawal of Life-sustaining Therapy in a Severely Impaired Child

Kathryn Miller, et al.

An infant with complex congenital heart disease suffers a prolonged cardiac arrest with minutes of anoxia. He is left with severe brain damage and profound neurologic impairment. He no longer responds to caregivers. Much of the time, he…

Ethical Issues in the Neonatal SUPPORT Trial

The controversy over the neonatal Surfactant, Positive Pressure, and Oximetry Randomized Trial (SUPPORT) study of oxygen saturation targets in extremely premature babies was intense and polarizing. The fundamental issue turned on whether…

Unilateral Withdrawal of Life-sustaining Therapy in a Severely Impaired Child.

Miller KE, et al.

An infant with complex congenital heart disease suffers a prolonged cardiac arrest with minutes of anoxia. He is left with severe brain damage and profound neurologic impairment. He no longer responds to caregivers. Much of the time, he…

Do Sociocultural Factors Influence Periviability Counseling and Treatment More Than Science? Lessons From Scandinavia.

Carter B, Garrett J

All of us (doctors, parents, bioethicists, and health policy makers) think differently about premature infants who require neonatal intensive care than we do about other patients who are critically ill. In most other clinical…

An Extravagant Gift From a Grateful Patient

Akshay Sharma, et al.

Gift giving is psychologically and culturally complex. In any context, a gift can have multiple meanings. In the context of the doctor-patient relationship, the giving of gifts and decisions about whether to accept gifts raise complex…

We Know Less Than We Think We Know About Perinatal Outcomes.

Most of what we think we know about survival rates for infants born at 22 or 23 weeks’ gestational age is probably wrong. It is wrong because of some well-recognized but oddly persistent quirks in the ways that outcome data are collected…

Medical Marijuana for Minors May Be Considered Child Abuse.

Hines L, et al.

The Food and Drug Administration categorizes marijuana (cannabis) as a Schedule I drug, meaning that it has no currently accepted medical use, a high potential for abuse, and no good data on safety. Other Schedule I drugs are heroin,…

Dismissal Policies for Vaccine Refusal—Reply

Michael J. Deem, Mark C. Navin

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Advocating for the DREAM Act: Why Pediatricians Should Care and What They Can Do.

Kuczewski M, Patel Z

* Abbreviations: DACA — : Deferred Action for Childhood Arrivals DREAM — : Development, Relief, and Education for Alien Minors Deferred Action for Childhood Arrivals (DACA) recipients are undocumented immigrants who were brought to the…

Medical Marijuana for Minors May Be Considered Child Abuse

Larissa Hines, et al.

The Food and Drug Administration categorizes marijuana (cannabis) as a Schedule I drug, meaning that it has no currently accepted medical use, a high potential for abuse, and no good data on safety. Other Schedule I drugs are heroin,…

Neonatal Autopsy and Parental Grief

Jessica Brunkhorst, et al.

Background: Details surrounding the death of child leave a lasting impression on families. The decision to have an autopsy is one aspect of end-of-life care that can be particularly troublesome. The medical benefits of autopsy have been…

Look to Scandinavia

Lars Ursin, Janicke Syltern

Should the rest of the world look to Scandinavian neonatal intensive care? In this special supplement, Scandinavian and international clinicians and bioethicists present, compare, and discuss the legislation, national guidelines, consensus…

Dismissal Policies for Vaccine Refusal-Reply.

Deem MJ, Navin MC

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

When Residents Let Conscience Be Their Guide: Professional Development and Educational Opportunity.

Shubkin CD, Garrett JR

Residency is a time of professional identity formation. During this time, residents may first be exposed to conflicts between professional duties and personal beliefs which may lead to a request for a conscience-based exemption. Faculty,…

Attitudes of paediatric and obstetric specialists towards prenatal surgery for lethal and non-lethal conditions.

Antiel RM, et al.

BACKGROUND: While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians'…

An Extravagant Gift From a Grateful Patient.

Sharma A, et al.

Gift giving is psychologically and culturally complex. In any context, a gift can have multiple meanings. In the context of the doctor-patient relationship, the giving of gifts and decisions about whether to accept gifts raise complex…

Ethical Problems in Decision Making in the Neonatal ICU

Technological advances have altered the boundary between viable and nonviable newborns and increased the need to consider quality of life in intervention decisions. An approach to decision making that accounts for the complexity of family…

Considering Family Resources When Making Medical Recommendations.

Iyengar A, Lewin S

Poor families without health insurance present unique challenges for pediatricians who want to do what is best for the children who are their patients. Families are often willing to make tremendous sacrifices to pay for recommended and…

Parents Refusing Dialysis for a 3-Month-Old With Renal Failure

Laurel K. Willig, et al.

A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed…

Pediatricians and court appointed special advocates (CASA)

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Controversy About a High-Risk and Innovative Fetal Cardiac Intervention

Lindsay A. Edwards, et al.

A 20-week-old fetus was diagnosed with critical pulmonary valve stenosis. Given the ultrasound findings, the outcome was difficult to predict. The fetal cardiologists discussed the possibility of a pulmonary valvuloplasty (an experimental…

Best Interest, Harm, God’s Will, Parental Discretion, or Utility

The impassioned and well-reasoned essays in this edition of the journal all agree with two claims: (1) children have moral claims that should be protected and recognized, and (2) we need ongoing

Pediatricians and court appointed special advocates (CASA).

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Growth Hormone Therapy for a Child With Severe Cognitive Impairment

Vincent E. Horne, et al.

The expansion of growth hormone therapy over the last 3 decades has allowed for treatment of short stature for more children, resulting in increased height for many. However, treatment of idiopathic short stature remains controversial.…

Should a Teenager Be Allowed to Leave the Hospital AMA to Attend His Father’s Funeral?

Thomas Kania, et al.

discussion, we examine the legality, morality, and safety of discharging a minor under such

Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians.

Deem MJ, Navin MC

This Viewpoint assesses the ethical and practical implications of a 2016 resolution by the American Academy of Pediatrics on the acceptability of dismissing vaccine-refusing parents from pediatric clinical

Sequencing Newborns:A Call for Nuanced Use of Genomic Technologies

Josephine Johnston, et al.

Many scientists and doctors hope that affordable genome sequencing will lead to more personalized medical care and improve public health in ways that will benefit children, families, and society more broadly. One hope in particular is that…

Pediatric Participation in Medical Decision Making: Optimized or Personalized?

Maya Sabatello, et al.

Olszewski and Goldkind (2018) argue that children's participation in medical decision making should be “the default position” and that a stepwise approach is needed to ensure that children are

Should a Teenager Be Allowed to Leave the Hospital AMA to Attend His Father's Funeral?

Kania T, et al.

discussion, we examine the legality, morality, and safety of discharging a minor under such

Recommendations for the design of therapeutic trials for neonatal seizures

Janet S. Soul, et al.

Although seizures have a higher incidence in neonates than any other age group and are associated with significant mortality and neurodevelopmental disability, treatment is largely guided by physician preference and tradition, due to a…

Fertility Preservation for a Transgender Teenager

Leena Nahata, et al.

In this article, we discuss a case in which a 16-year-old birth-assigned male came out to her parents as transgender. She is referred to the gender management program at a large pediatric academic center to discuss hormone therapy. She was…

Look to Scandinavia.

Ursin L, Syltern J

Should the rest of the world look to Scandinavian neonatal intensive care? In this special supplement, Scandinavian and international clinicians and bioethicists present, compare, and discuss the legislation, national guidelines, consensus…

When Parents Have Misunderstandings About the Risks and Benefits of Palliative Surgery.

Robins B, Booser A

When a child needs surgery, both the surgeon and the anesthesiologist must obtain informed consent from the parents. In theory, each specialist obtains permission for their respective portion of the procedure, with the anesthesiologist…

Sequencing Newborns: A Call for Nuanced Use of Genomic Technologies.

Johnston J, et al.

Many scientists and doctors hope that affordable genome sequencing will lead to more personalized medical care and improve public health in ways that will benefit children, families, and society more broadly. One hope in particular is that…

Please Test My Child for a Cancer Gene, but Don’t Tell Her

Johan C. Bester, et al.

A 38-year-old woman is diagnosed with Li-Fraumeni syndrome, an autosomal dominant genetic condition that predisposes to a variety of cancers. The woman has an 11-year-old daughter. The geneticist recommends that the child be tested for the…

Prenatal AnxietiesImperfect Pregnancies: A History Of Birth Defects And Prenatal Diagnosis By Ilana Löwy Baltimore (MD): Johns Hopkins University Press, 2017 296 pp., $44.95

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Should Foreigners Get Costly Lifesaving Treatments in the United States?

Shane R. Wo, et al.

Many foreign parents bring their children to the United States for medical treatments that are unavailable in their own country. Often, however, parents cannot afford expensive treatments. Doctors and hospitals then face a dilemma. Is it…

Do Sociocultural Factors Influence Periviability Counseling and Treatment More Than Science? Lessons From Scandinavia

Brian S. Carter, Jeremy R. Garrett

All of us (doctors, parents, bioethicists, and health policy makers) think differently about premature infants who require neonatal intensive care than we do about other patients who are critically ill. In most other clinical…

Growth Hormone Therapy for a Child With Severe Cognitive Impairment.

Horne VE, et al.

The expansion of growth hormone therapy over the last 3 decades has allowed for treatment of short stature for more children, resulting in increased height for many. However, treatment of idiopathic short stature remains controversial.…

Should Pediatric Euthanasia be Legalized?

Marije Brouwer, et al.

Voluntary active euthanasia for adults at their explicit request has been legal in Belgium and the Netherlands since 2002. In those countries, acceptance of the practice for adults has been followed by acceptance of the practice for…

Please Test My Child for a Cancer Gene, but Don't Tell Her.

Bester J, et al.

A 38-year-old woman is diagnosed with Li-Fraumeni syndrome, an autosomal dominant genetic condition that predisposes to a variety of cancers. The woman has an 11-year-old daughter. The geneticist recommends that the child be tested for the…

Child Abuse, Incarceration, and Decisions About Life-sustaining Treatment.

Mann PC, et al.

Most critical care interventions for children occur in the framework of a supportive environment with loving parents that are present at the bedside to help to guide medical interventions through shared decision-making. What happens,…

Neonatal research ethics after SUPPORT.

The SUPPORT study (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments), sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development to evaluate different oxygen…

Controversy About a High-Risk and Innovative Fetal Cardiac Intervention.

Edwards LA, et al.

A 20-week-old fetus was diagnosed with critical pulmonary valve stenosis. Given the ultrasound findings, the outcome was difficult to predict. The fetal cardiologists discussed the possibility of a pulmonary valvuloplasty (an experimental…

What is the Purpose of Antenatal Counseling?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians

Michael J. Deem, Mark C. Navin

This Viewpoint assesses the ethical and practical implications of a 2016 resolution by the American Academy of Pediatrics on the acceptability of dismissing vaccine-refusing parents from pediatric clinical

We Know Less Than We Think We Know About Perinatal Outcomes

Most of what we think we know about survival rates for infants born at 22 or 23 weeks’ gestational age is probably wrong. It is wrong because of some well-recognized but oddly persistent quirks in the ways that outcome data are collected…

When Parents Have Misunderstandings About the Risks and Benefits of Palliative Surgery

Berklee Robins, Adam Booser

When a child needs surgery, both the surgeon and the anesthesiologist must obtain informed consent from the parents. In theory, each specialist obtains permission for their respective portion of the procedure, with the anesthesiologist…

Ethical Controversy About Hysterectomy for a Minor

Alyssa M. Burgart, et al.

One of the most complicated ethical issues that arises in children's hospitals today is the issue of whether it is ever permissible to perform a procedure for a minor that will result in permanent sterilization. In most cases, the answer…

Religious Traditions in a Postreligious World:

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Physician-Nurse Interactions in Critical Care

Sumaira Khowaja-Punjwani, et al.

Nearly 20% of nurses leave their first job within a year of being hired. Many do so because they perceive the work environment to be unhealthy or nonsupportive. Nurse turnover is costly. When new nurses leave within 3 years of being hired,…

Neonatal research ethics after SUPPORT

The SUPPORT study (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments), sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development to evaluate different oxygen…

Controversy About Dialysis for an Adolescent

Tyler Tate, et al.

For patients on dialysis, 1 frequent cause of death is their voluntary decision to discontinue dialysis. Such decisions raise complex questions when the patient is a competent adult. The decisions are even more complex when the patient is…

Ethical Concerns When Minors Act as Standardized Patients.

Khoo EJ, et al.

When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations…

A Parent Reveals the Biases That she Faced to get Care for her Daughter

Sosha Chaney

A poor, African-American mother describes the difficulties that she has in getting a comprehensive medical evaluation for her child in an Emergency Room. Eventually, she finds the care and the caring that she needs at a medical clinic in a…

The Tragic Case of Charlie Gard

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

A Novel Partnership Disrupts the Norm in Early Childhood Education and Pediatric Health Care.

Dowd MD

Children living in poverty in the United States in 2016 face a devastating combination of psychological problems. Their neighborhoods are often violent. They have no place to get healthy food. It is not safe to play outside, even on…

Ethical Concerns When Minors Act as Standardized Patients

Erwin Jiayuan Khoo, et al.

When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations…

Informed Consent for Comparative Effectiveness Research Should Not Consider the Risks of the Standard Therapies That Are Being Studied as Risks of the Research

There is a debate at the highest levels of government about how to classify the risks of research studies that evaluate therapies that are in widespread use. Should the risks of those therapies be considered as risks of research that is…

Grief and Burnout in the PICU.

Crowe S, et al.

Doctors and nurses who work in PICUs often deal with emotionally difficult events. These events take a toll. They can cause long-term psychological problems that, if not addressed, can impair the ability of doctors and nurses to care for…

Surrogate Pregnancy After Prenatal Diagnosis of Spina Bifida.

Mazur LJ, et al.

Some pregnancies today involve infertile individuals or couples who contract with a fertile woman to carry a pregnancy for them. The woman who carries the pregnancy is referred to as a "gestational carrier." The use of such arrangements is…

Contributors

Kabir Abubakar, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Physician views regarding the benefits and burdens of prenatal surgery for myelomeningocele

Ryan M. Antiel, et al.

OBJECTIVE: Examine how pediatric and obstetrical subspecialists view benefits and burdens of prenatal myelomeningocele (MMC) closure. STUDY DESIGN: Mail survey of 1200 neonatologists, pediatric surgeons and maternal-fetal medicine…

Surrogate Pregnancy After Prenatal Diagnosis of Spina Bifida

Lynnette J. Mazur, et al.

Some pregnancies today involve infertile individuals or couples who contract with a fertile woman to carry a pregnancy for them. The woman who carries the pregnancy is referred to as a "gestational carrier." The use of such arrangements is…

Grief and Burnout in the PICU

Suzanne M. Crowe, et al.

Doctors and nurses who work in PICUs often deal with emotionally difficult events. These events take a toll. They can cause long-term psychological problems that, if not addressed, can impair the ability of doctors and nurses to care for…

Weighing the Social and Ethical Considerations of Maternal-Fetal Surgery.

Antiel RM, et al.

OBJECTIVES: The ethics of maternal-fetal surgery involves weighing the importance of potential benefits, risks, and other consequences involving the pregnant woman, fetus, and other family members. We assessed clinicians' ratings of the…

Ethics Rounds: Parents Refusing Dialysis for a 3-month-old with Renal Failure

Laurel K. Willig, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Why Are There So Few Ethics Consults in Children’s Hospitals?

Brian S. Carter, et al.

In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues…

The Tragic Case of Charlie Gard.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Genomic Contraindications for Heart Transplantation

Danton Char, et al.

Genome sequencing raises new ethical challenges. Decoding the genome produces new forms of diagnostic and prognostic information; however, the information is often difficult to interpret. The connection between most genetic variants and…

The Dilemma of Predicting Violent Radicalization

Cécile Rousseau, B. Heidi Ellis

Parents, educators, law enforcement officials, and health professionals are all concerned about the violent radicalization of adolescents. Health professionals may be called on to assess teenagers regarding the risk that they will become…

Controversy About Dialysis for an Adolescent.

Tate T, et al.

For patients on dialysis, 1 frequent cause of death is their voluntary decision to discontinue dialysis. Such decisions raise complex questions when the patient is a competent adult. The decisions are even more complex when the patient is…

Ethical Controversy About Hysterectomy for a Minor.

Burgart AM, et al.

One of the most complicated ethical issues that arises in children's hospitals today is the issue of whether it is ever permissible to perform a procedure for a minor that will result in permanent sterilization. In most cases, the answer…

Advocating for the DREAM Act: Why Pediatricians Should Care and What They Can Do

Mark G. Kuczewski, Zarna Patel

* Abbreviations: DACA — : Deferred Action for Childhood Arrivals DREAM — : Development, Relief, and Education for Alien Minors Deferred Action for Childhood Arrivals (DACA) recipients are undocumented immigrants who were brought to the…

Physician-Nurse Interactions in Critical Care.

Khowaja-Punjwani S, et al.

Nearly 20% of nurses leave their first job within a year of being hired. Many do so because they perceive the work environment to be unhealthy or nonsupportive. Nurse turnover is costly. When new nurses leave within 3 years of being hired,…

Genomic Contraindications for Heart Transplantation.

Char DS, et al.

Genome sequencing raises new ethical challenges. Decoding the genome produces new forms of diagnostic and prognostic information; however, the information is often difficult to interpret. The connection between most genetic variants and…

When Residents Let Conscience Be Their Guide: Professional Development and Educational Opportunity

Catherine D. Shubkin, Jeremy R. Garrett

Residency is a time of professional identity formation. During this time, residents may first be exposed to conflicts between professional duties and personal beliefs which may lead to a request for a conscience-based exemption. Faculty,…

Trust in the Medical Profession Among Adolescents in an Emergency Department

Kelstan Ellis, et al.

Objective The aims of this study were to assess trust in the medical profession among adolescents in an urban pediatric emergency department (ED) and explore factors associated with trust. Methods We used a computerized survey to assess…

The regulation of clinical research: What's love got to do with it?

The central philosophical pillar of the current system of research regulation in the United States today is that clinical investigators cannot and should not be trusted to protect the interests of the people whom they recruit to…

Specialty-Based Variation in Applying Maternal-Fetal Surgery Trial Evidence

Ryan M. Antiel, et al.

INTRODUCTION: The Management of Myelomeningocele Study (MOMS) compared prenatal with postnatal surgery for fetal myelomeningocele (MMC). We sought to understand how subspecialists interpreted the trial results and whether their practice…

Specialty-Based Variation in Applying Maternal-Fetal Surgery Trial Evidence.

Antiel RM, et al.

INTRODUCTION: The Management of Myelomeningocele Study (MOMS) compared prenatal with postnatal surgery for fetal myelomeningocele (MMC). We sought to understand how subspecialists interpreted the trial results and whether their practice…

Weighing the Social and Ethical Considerations of Maternal-Fetal Surgery

Ryan M. Antiel, et al.

OBJECTIVES: The ethics of maternal-fetal surgery involves weighing the importance of potential benefits, risks, and other consequences involving the pregnant woman, fetus, and other family members. We assessed clinicians' ratings of the…

A Parent Reveals the Biases That she Faced to get Care for her Daughter.

Chaney S

A poor, African-American mother describes the difficulties that she has in getting a comprehensive medical evaluation for her child in an Emergency Room. Eventually, she finds the care and the caring that she needs at a medical clinic in a…

Considering Family Resources When Making Medical Recommendations

Arpana Iyengar, Sanjiv Lewin

Poor families without health insurance present unique challenges for pediatricians who want to do what is best for the children who are their patients. Families are often willing to make tremendous sacrifices to pay for recommended and…

Blowing the whistle: moral distress and advocacy for preterm infants and their families

Annie Janvier, Trisha Prentice

Although the majority of extremely preterm infants now survive with good outcomes, some of these fragile babies die or survive with severe disabilities. In the past, physicians were appropriately cautious about treating all preterm infants…

Neonatologists' opinions about the 'foreseeable risks' in comparative effectiveness research: Results from an online survey.

Feltman DM

OBJECTIVE: To examine how neonatologists determine which risks require inclusion for informed consent per the 'Common Rule' and 'Draft Guidance' regulations in comparative effectiveness research (CER). STUDY DESIGN: Neonatologists active…

To Whom Do Children Belong?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A Novel Partnership Disrupts the Norm in Early Childhood Education and Pediatric Health Care

M. Denise Dowd

Children living in poverty in the United States in 2016 face a devastating combination of psychological problems. Their neighborhoods are often violent. They have no place to get healthy food. It is not safe to play outside, even on…

The Dilemma of Predicting Violent Radicalization.

Rousseau C, Ellis BH

Parents, educators, law enforcement officials, and health professionals are all concerned about the violent radicalization of adolescents. Health professionals may be called on to assess teenagers regarding the risk that they will become…

Attitudes of paediatric and obstetric specialists towards prenatal surgery for lethal and non-lethal conditions

Ryan M. Antiel, et al.

BACKGROUND: While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians'…

Prognostic neurodevelopmental testing of preterm infants: do we need to change the paradigm?

Howard W. Kilbride, et al.

Longitudinal follow-up with assessment of developmental status at about 2 years of age is routine for high-risk newborns. The results of these assessments can be used for many purposes, including helping physicians, parents, and teachers…

Physician views regarding the benefits and burdens of prenatal surgery for myelomeningocele.

Antiel RM, et al.

OBJECTIVE: Examine how pediatric and obstetrical subspecialists view benefits and burdens of prenatal myelomeningocele (MMC) closure. STUDY DESIGN: Mail survey of 1200 neonatologists, pediatric surgeons and maternal-fetal medicine…

Ethical Issues in Assisted Ventilation of the Neonate

Julie Weiner, Jessica Brunkhorst

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Introduction to Bioethics Special Supplement V: Ethical Issues in Genomic Testing of Children

Next-generation genome sequencing of children is one of the most promising and most challenging new technologies in pediatrics. On the one hand, it offers the hope that we will be able to diagnose rare conditions that were previously…

Should Neonatologists Give Opinions Withdrawing Life-sustaining Treatment?

J. S. Blumenthal‐Barby, et al.

An infant has a massive intracranial hemorrhage. She is neurologically devastated and ventilator-dependent. The prognosis for pulmonary or neurologic recovery is bleak. The physicians and parents face a choice: withdraw the ventilator and…

Thirteen Ways of Looking at Henrietta Lacks.

Wallace Stevens's 1917 poem "Thirteen Ways of Looking at a Blackbird" suggests that what we see is never simply what is there. This essay presents 13 ways of looking at Henrietta Lacks (1920-1951), whose cultured cells were used to create…

Randomized n-of-1 Trials: Quality Improvement, Research, or Both?

Joyce P. Samuel, et al.

The regulatory demarcations between clinical research and quality improvement (QI) are ambiguous and controversial. Some projects that were undertaken as a form of QI were deemed by regulatory agencies to be research and thus to require…

Medical Therapy for Inappropriate Sexual Behaviors in a Teen With Autism Spectrum Disorder.

Coshway L, et al.

Teens with autism spectrum disorder often exhibit sexual behaviors in public that are disturbing to parents, teachers, and peers. Some have proposed that such behaviors can be curtailed with hormonal suppression. There is information on…

Editors’ Introduction

Franklin G. Miller

Editors’ Introduction Franklin G. Miller and John Lantos On June 16, 1966, the New England Journal of Medicine published “Ethics and Clinical Research” by Henry K. Beecher. Beecher’s account of 22 examples of unethical contemporary…

Withholding Information to Protect a Loved One

Todd J. Kilbaugh, et al.

Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father's reaction to his…

Ethics Rounds: In the Eye of a Social Media Storm

Donna D. McKlindon, et al.

Social media, no stranger to health care environments, is increasingly used by patients, families, clinicians, and institutions to interact and engage in new ways. The ethical challenges related to the use of social media in the clinical…

When a Surgical Colleague Makes an Error.

Antiel RM, et al.

Professionalism requires that doctors acknowledge their errors and figure out how to avoid making similar ones in the future. Over the last few decades, doctors have gotten better at acknowledging mistakes and apologizing to patients when…

Henry K. Beecher and the Oversight of Research in Children

Henry K. Beecher was a pioneer of research ethics and a prominent whistleblower with regard to ethically problematic studies. Most of his work focused on research in adults, not children, but he did speculate about the implications of his…

Considering Decision-Making and Sexuality in Menstrual Suppression of Teens and Young Adults with Intellectual Disabilities

Kruti Acharya

Case Dr. Jones is a gynecologist who has been seeing Amy for the past few years to help with menstrual suppression. Amy was diagnosed with cerebral palsy at birth; she experienced some global developmental delay as a child and was in…

When a Surgical Colleague Makes an Error

Ryan M. Antiel, et al.

Professionalism requires that doctors acknowledge their errors and figure out how to avoid making similar ones in the future. Over the last few decades, doctors have gotten better at acknowledging mistakes and apologizing to patients when…

Please Do Whatever It Takes to End Our Daughter's Suffering!

Clément de Cléty S, et al.

What is the best way to care for a child with severe neurologic impairment who seems to be dying and is in intractable pain? Can we give sedation as we remove life support? Is it ethically permissible to hasten death? In the United States,…

Introduction to Bioethics Special Supplement V: Ethical Issues in Genomic Testing of Children.

Next-generation genome sequencing of children is one of the most promising and most challenging new technologies in pediatrics. On the one hand, it offers the hope that we will be able to diagnose rare conditions that were previously…

Reason, Emotion, and Implanted Devices

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Should Pediatric Practices Have Policies to Not Care for Children With Vaccine-Hesitant Parents?

Kenneth Alexander, et al.

One of the most divisive issues in pediatrics today concerns the proper response by pediatricians to parents who refuse routine childhood immunizations for their children. Many pediatricians refuse to care for such families. Others…

One Exemption Too Many: The Case for Mandated CCHD Screening.

Caciki J, Garrett JR

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

One Exemption Too Many: The Case for Mandated CCHD Screening

Julie Caciki, Jeremy R. Garrett

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Learning to Listen, Listening to Learn

Abstract The dust‐jacket photo of Eric Cassell portrays him as a magician. He wears a dark suit, a bow tie, and big dark‐rimmed glasses. His head is tilted down; his forehead is massive; his eyes are intense. It is an interrogating look…

Ethics Rounds: In the Eye of a Social Media Storm.

McKlindon D, et al.

Social media, no stranger to health care environments, is increasingly used by patients, families, clinicians, and institutions to interact and engage in new ways. The ethical challenges related to the use of social media in the clinical…

Reason, Emotion, and Implanted Devices.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Medical Therapy for Inappropriate Sexual Behaviors in a Teen With Autism Spectrum Disorder

Loyal Coshway, et al.

Teens with autism spectrum disorder often exhibit sexual behaviors in public that are disturbing to parents, teachers, and peers. Some have proposed that such behaviors can be curtailed with hormonal suppression. There is information on…

The Challenge of Analyzing the Results of Next-Generation Sequencing in Children

Isabelle Thiffault

In recent years, next-generation sequencing technologies have revolutionized approaches to genetic studies. Whole-exome or whole-genome sequencing allows diagnoses in many patients who have complex phenotypes and unusual clinical…

A survey of paediatricians on the use of electrocardiogram for pre-participation sports screening

Angira Patel, et al.

Aim The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE). METHODS:…

Should School Boards Discontinue Support for High School Football?

Lewis H. Margolis, et al.

A pediatrician is asked by her local school board to help them decide whether to discontinue their high school football program. She reviews the available evidence on the risks of football and finds it hopelessly contradictory. Some…

What If the Prenatal Diagnosis of a Lethal Anomaly Turns Out to Be Wrong?

André Kidszun, et al.

Advances in prenatal diagnosis create a unique set of clinical ethics dilemmas. Doctors routinely obtain genetic screening, radiologic images, and biophysical profiling. These allow more accurate diagnosis and prognosis than has ever…

Considering Decision-Making and Sexuality in Menstrual Suppression of Teens and Young Adults with Intellectual Disabilities.

Acharya K

Case Dr. Jones is a gynecologist who has been seeing Amy for the past few years to help with menstrual suppression. Amy was diagnosed with cerebral palsy at birth; she experienced some global developmental delay as a child and was in…

Neonatologists’ opinions about the ‘foreseeable risks’ in comparative effectiveness research: Results from an online survey

Dalia M. Feltman

OBJECTIVE: To examine how neonatologists determine which risks require inclusion for informed consent per the 'Common Rule' and 'Draft Guidance' regulations in comparative effectiveness research (CER). STUDY DESIGN: Neonatologists active…

University of Pennsylvania 8th annual conference on statistical issues in clinical trials: Pragmatic clinical trials (morning panel).

Dodd LE, Pinheiro J

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Withholding Information to Protect a Loved One.

Kilbaugh TJ, et al.

Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father's reaction to his…

Randomized n-of-1 Trials: Quality Improvement, Research, or Both?

Samuel JP, et al.

The regulatory demarcations between clinical research and quality improvement (QI) are ambiguous and controversial. Some projects that were undertaken as a form of QI were deemed by regulatory agencies to be research and thus to require…

University of Pennsylvania 8th annual conference on statistical issues in clinical trials: Pragmatic clinical trials (morning panel)

Lori E. Dodd, José Cirı́aco Pinheiro

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Thirteen Ways of Looking at Henrietta Lacks

Wallace Stevens's 1917 poem "Thirteen Ways of Looking at a Blackbird" suggests that what we see is never simply what is there. This essay presents 13 ways of looking at Henrietta Lacks (1920-1951), whose cultured cells were used to create…

Author’s Response

Three ethical principles govern research with human subjects: respect for persons, beneficence, and justice. Respect for persons demands that, whenever feasible, we ask parents for permission before enrolling their infants in research…

Making Tough Ethical Choices in a Morally Pluralistic World

BACKGROUND: Paramedics make important and increasingly complex decisions at scene about patient care. Patient safety implications of influences on decision making in the pre-hospital setting were previously under-researched. Cutting edge…

Should All Deaf Children Learn Sign Language?

Donna Jo Napoli, et al.

Every year, 10,000 infants are born in the United States with sensorineural deafness. Deaf children of hearing (and nonsigning) parents are unique among all children in the world in that they cannot easily or naturally learn the language…

U.S. Research Regulations: Do They Reflect the Views of the People They Claim to Protect?

Editorials19 May 2015U.S. Research Regulations: Do They Reflect the Views of the People They Claim to Protect?John D. Lantos, MDJohn D. Lantos, MDFrom Children's Mercy Hospitals and Clinics, Kansas City, Missouri.Author, Article, and…

Considerations in the evaluation and determination of minimal risk in pragmatic clinical trials.

et al.

Institutional review boards, which are charged with overseeing research, must classify the riskiness of proposed research according to a federal regulation known as the Common Rule (45 CFR 46, Subpart A) and by regulations governing the US…

Please Do Whatever It Takes to End Our Daughter’s Suffering!

Stephan Clément de Clety, et al.

What is the best way to care for a child with severe neurologic impairment who seems to be dying and is in intractable pain? Can we give sedation as we remove life support? Is it ethically permissible to hasten death? In the United States,…

Preterm Babies, Fetal Patients, and Childbearing Choices

Diane S. Lauderdale

Why preterm birth rates in the United States remain high even as access to prenatal care has improved and infant mortality has steadily dropped. The United States has one of the highest rates of premature birth of any industrialized…

When a Family Requests a White Doctor

Kimberly L. Reynolds, et al.

Parents sometimes request that a doctor of a particular race or ethnic group not care for their child. Such requests sometimes seem legitimate and other times seem offensive. The difference reflects a clash of fundamental values.…

Do Patients Want to Participate in Decisions About Their Own Medical Care?

"Do Patients Want to Participate in Decisions About Their Own Medical Care?." The American Journal of Bioethics, 15(10), pp.

Author’s Response Deaf Children, Cochlear Implants, and Language Acquisition

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Use of altered informed consent in pragmatic clinical research.

McKinney RE, et al.

There are situations in which the requirement to obtain conventional written informed consent can impose significant or even insurmountable barriers to conducting pragmatic clinical research, including some comparative effectiveness…

Author's Response.

Three ethical principles govern research with human subjects: respect for persons, beneficence, and justice. Respect for persons demands that, whenever feasible, we ask parents for permission before enrolling their infants in research…

Risks in a Trial of an Innovative Treatment of Duchenne Muscular Dystrophy

Wendy Bos, et al.

Studies of innovative therapies for muscular dystrophy raise unique ethical issues. The disease is currently untreatable and relentlessly progressive. A number of potentially efficacious treatments are being developed, but like all…

Is a New Protocol for Acute Lymphoblastic Leukemia Research or Standard Therapy?

Sara A. S. Dekking, et al.

In the United States, doctors generally develop new cancer chemotherapy for children by testing innovative chemotherapy protocols against existing protocols in prospective randomized trials. In the Netherlands, children with leukemia are…

Risks in a Trial of an Innovative Treatment of Duchenne Muscular Dystrophy.

Bos W, et al.

Studies of innovative therapies for muscular dystrophy raise unique ethical issues. The disease is currently untreatable and relentlessly progressive. A number of potentially efficacious treatments are being developed, but like all…

Harmonization and streamlining of research oversight for pragmatic clinical trials.

O'Rourke PP, et al.

The oversight of research involving human participants is a complex process that requires institutional review board review as well as multiple non-institutional review board institutional reviews. This multifaceted process is particularly…

136. Do Adolescents Trust Doctors?

Melissa K. Miller, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Bullying, social hierarchies, poverty, and health outcomes.

Halpern J

This Bioethics Special Supplement started out with a narrow focus on bullying.We thought that the issues associated with bullying among children and teenagers deserved the attention of bioethicists. We were specifically interested in why…

Two Infants, Same Prognosis, Different Parental Preferences

Armand H. Matheny Antommaria, et al.

A central principle of justice is that similar cases should be decided in similar ways. In pediatrics, however, there are cases in which 2 infants have similar diagnoses and prognoses, but their parents request different treatments. In…

Children

Abstract John Lantos takes up the subject of the deaths of children. Attempting to make sense of the deep suffering and “radical uncertainty” that accompany such deaths, he appeals to both narrative and empirical studies. Lantos shows that…

Considerations in the evaluation and determination of minimal risk in pragmatic clinical trials

et al.

Institutional review boards, which are charged with overseeing research, must classify the riskiness of proposed research according to a federal regulation known as the Common Rule (45 CFR 46, Subpart A) and by regulations governing the US…

Frontiers: Integration of a Research Participant Registry with Medical Clinic Registration and Electronic Health Records.

Kluding PM, et al.

Participant recruitment is a significant challenge to the success of clinical research. Without sufficient study participants, investigators cannot meet accrual goals and studies either must be abandoned without reaching recruitment…

Muddled measures of risks and misremembered reasons.

Feudtner C

Abstract A commentary on “Were There ‘Additional Foreseeable Risks’ in the SUPPORT Study?,” by Henry J. Silverman and Didier Dreyfuss; “SUPPORT: Risks, Harms, and Equipoise,” by Robert M. Nelson; “The Controversy over SUPPORT Continues and…

Should we tell parents when we've made an error?

Bell SK, et al.

One of the most difficult experiences for any doctor or nurse is when they realize that they have made a mistake that has harmed a patient. In the past, mistakes were seldom disclosed to patients. The prevailing ethos was one of…

Authorship Concerns and Who Truly Owns a Research Idea?

Sana Syed, et al.

Researchers often face dilemmas about authorship. When the researchers are graduate students, fellows, or junior faculty, the dilemmas might involve discussions about fair criteria for more senior faculty to be acknowledged as key…

International and cross-cultural dimensions of treatment decisions for neonates.

Neonatal mortality rates vary widely among countries. According to data from the World Health Organization, neonatal mortality in low- and low-middle-income countries is ∼30 per 1000 babies. In upper middle-income countries, that number…

Transcending differences to study the transcendent: an exploratory study of researchers’ and chaplains’ reflections on interdisciplinary spiritual care research collaboration

Richard A. Powell, et al.

BACKGROUND: Despite recognition of the centrality of professional board-certified chaplains (BCC) in palliative care, the discipline has little research to guide its practices. To help address this limitation, HealthCare Chaplaincy Network…

Author's Response: Deaf Children, Cochlear Implants, and Language Acquisition.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Use of altered informed consent in pragmatic clinical research

Ross E. McKinney, et al.

There are situations in which the requirement to obtain conventional written informed consent can impose significant or even insurmountable barriers to conducting pragmatic clinical research, including some comparative effectiveness…

Muddled Measures of Risks and Misremembered Reasons

Chris Feudtner

Abstract A commentary on “Were There ‘Additional Foreseeable Risks’ in the SUPPORT Study?,” by Henry J. Silverman and Didier Dreyfuss; “SUPPORT: Risks, Harms, and Equipoise,” by Robert M. Nelson; “The Controversy over SUPPORT Continues and…

Ethical and Psychosocial Issues in Whole-Genome Sequencing for Newborns

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Two infants, same prognosis, different parental preferences.

Antommaria AH, et al.

A central principle of justice is that similar cases should be decided in similar ways. In pediatrics, however, there are cases in which 2 infants have similar diagnoses and prognoses, but their parents request different treatments. In…

Bullying, Social Hierarchies, Poverty, and Health Outcomes

Jodi Halpern

This Bioethics Special Supplement started out with a narrow focus on bullying.We thought that the issues associated with bullying among children and teenagers deserved the attention of bioethicists. We were specifically interested in why…

The concept of risk in comparative effectiveness research.

Spertus JA

The OHRP issued draft guidelines requiring disclosure of all risks of standard treatments in comparative-effectiveness research. The authors argue that such risks are not risks of participation in research and that the proposal will…

International and cross-cultural dimensions of treatment decisions for neonates

Neonatal mortality rates vary widely among countries. According to data from the World Health Organization, neonatal mortality in low- and low-middle-income countries is ∼30 per 1000 babies. In upper middle-income countries, that number…

Ethics and Etiquette in Neonatal Intensive Care—Reply

Annie Janvier

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Vindication for SUPPORT

A judge has dismissed a lawsuit alleging that fully informed consent was not obtained from parents of infants in the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, which compared two oxygen-saturation targets, both within…

Vindication for SUPPORT.

A judge has dismissed a lawsuit alleging that fully informed consent was not obtained from parents of infants in the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, which compared two oxygen-saturation targets, both within…

List of Contributors

Zofia T. Bilińska, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When a Family Requests a White Doctor.

Reynolds KL, et al.

Parents sometimes request that a doctor of a particular race or ethnic group not care for their child. Such requests sometimes seem legitimate and other times seem offensive. The difference reflects a clash of fundamental values.…

Harmonization and streamlining of research oversight for pragmatic clinical trials

P. Pearl O’Rourke, et al.

The oversight of research involving human participants is a complex process that requires institutional review board review as well as multiple non-institutional review board institutional reviews. This multifaceted process is particularly…

Frontiers: Integration of a Research Participant Registry with Medical Clinic Registration and Electronic Health Records

Patricia M. Kluding, et al.

Participant recruitment is a significant challenge to the success of clinical research. Without sufficient study participants, investigators cannot meet accrual goals and studies either must be abandoned without reaching recruitment…

Are We Allowed to Discontinue Medical Treatment in This Child?

Wendela G. Leeuwenburgh-Pronk, et al.

One of the most difficult ethical dilemmas in pediatrics today arises when a child has complex chronic conditions that are not curable and cause discomfort with no prospect of any improvement on quality of life. In the context of medical…

The Concept of Risk in Comparative Effectiveness Research

John A. Spertus

The OHRP issued draft guidelines requiring disclosure of all risks of standard treatments in comparative-effectiveness research. The authors argue that such risks are not risks of participation in research and that the proposal will…

The Patient-Parent-Pediatrician Relationship: Everyday Ethics in the Office

Pediatricians and parents generally try to do what is best for children, but they do not always agree about what that is. Mothers and fathers may disagree with each other. Parents may disagree with pediatricians. Disagreements can arise…

Engaging Pediatric Health Professionals in Interactive Online Ethics Education

Diane M. Plantz, et al.

Abstract Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to…

Who Should Get the Last PICU Bed?

Aaron Wightman, et al.

Administrators sometimes face ethical dilemmas about the allocation of institutional resources. One such situation is when elective surgery cases require reserved ICU beds and the ICU is full. Such situations arise frequently in children's…

Ethical Issues in Fetal Diagnosis and Treatment

Conor McMann, Brian S. Carter

Fetal diagnosis has raised ethical issues since it was first developed in the 1940s and 1950s. Two controversial issues have predominated. First, when the techniques for prenatal diagnosis were invasive techniques, they created risks to…

Human Subjects Protection: An Event Monitoring Committee for Research Studies of Girls From Breast Cancer Families

Diana Harris, et al.

PURPOSE: Researchers must monitor the safety of research participants, particularly in studies involving children and adolescents. Yet, there is limited guidance for the development and implementation of oversight committees for…

A 6-month-old with vaccine-hesitant parents.

Opel DJ, et al.

Many primary care pediatricians find vaccine hesitancy to be one of the most frustrating situations that they face. Parents who refuse to vaccinate their children implicitly call into question an intervention that most pediatricians see as…

Should We Tell Parents When We’ve Made an Error?

Sigall K. Bell, et al.

One of the most difficult experiences for any doctor or nurse is when they realize that they have made a mistake that has harmed a patient. In the past, mistakes were seldom disclosed to patients. The prevailing ethos was one of…

Mechanical Ventilation for a Child With Quadriplegia

William E. Novotny, et al.

Parents generally have the right to make medical decisions for their children. This right can be challenged when the parents' decision seems to go against the child's interests. The toughest such decisions are for a child who will survive…

A 6-Month-Old With Vaccine-Hesitant Parents

Douglas J. Opel, et al.

Many primary care pediatricians find vaccine hesitancy to be one of the most frustrating situations that they face. Parents who refuse to vaccinate their children implicitly call into question an intervention that most pediatricians see as…

Mechanical ventilation for a child with quadriplegia.

Novotny WE, et al.

Parents generally have the right to make medical decisions for their children. This right can be challenged when the parents' decision seems to go against the child's interests. The toughest such decisions are for a child who will survive…

Learning the right lessons from the SUPPORT study controversy.

Ten years ago, there was well-known and widespread practice variation in the levels of oxygen that neonatologists provided to premature babies.1 Neonatal intensive care units (NICUs) targeted oxygen saturations ranging from 82% to 100%.…

Whose Interests Count?

Daniel Brudney

Whose interests should count and how should various interests be balanced at the pediatric patient's bedside? The interests of the child patient clearly count. Recently, however, many authors have argued that the family's interests also…

Ethical issues in fetal diagnosis and treatment.

McMann CL, Carter BS

Fetal diagnosis has raised ethical issues since it was first developed in the 1940s and 1950s. Two controversial issues have predominated. First, when the techniques for prenatal diagnosis were invasive techniques, they created risks to…

Was Sarah Murnaghan Treated Justly?

Jennifer deSante, et al.

Lung transplantation is a potentially life-saving procedure for patients with irreversible lung failure. Five-year survival rates after lung transplantation are >50% for children and young adults. But there are not enough lungs to save…

The Slow, Steady Development of Pediatric Ethics Committees, 1975-2013

Douglas D. Myers

have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/ investigative use of a commercial product/ device. During the last 30 years, most children’s hospitals in…

Perspectives on anticipated quality-of-life and recommendations for neonatal intensive care: a survey of neonatal providers

Kirsten Salmeen, et al.

OBJECTIVE: Explore associations between neonatal providers' perspectives on survival, quality of life (QOL) and treatment recommendations. METHODS: Providers attending a workshop on neonatal viability were surveyed about survival,…

When Is Waiver of Consent Appropriate in a Neonatal Clinical Trial?

Mark S. Schreiner, et al.

It is difficult to do scientifically rigorous research on treatments that must be administered urgently or emergently. Therefore, such treatments are often provided without a strong evidence base. Research would be facilitated if it were…

The Concept of Risk in Comparative-Effectiveness Research

John A. Spertus

The OHRP issued draft guidelines requiring disclosure of all risks of standard treatments in comparative-effectiveness research. The authors argue that such risks are not risks of participation in research and that the proposal will…

What We talk about When We Talk about Ethics

Abstract I was recently invited to talk about ethics with the staff of a level‐three neonatal intensive care unit. They presented a case featuring a full‐term baby born by emergency caesarean‐section after a cord prolapse that caused…

Ethics and Etiquette in Neonatal Intensive Care

Annie Janvier

When parents voice their dissatisfaction with the neonatal intensive care unit (NICU), it is often not because they think their baby has not received good medical care. Instead, it is often because their needs have not been addressed.…

The concept of risk in comparative-effectiveness research.

Spertus JA

The OHRP issued draft guidelines requiring disclosure of all risks of standard treatments in comparative-effectiveness research. The authors argue that such risks are not risks of participation in research and that the proposal will…

What we talk about when we talk about ethics.

Abstract I was recently invited to talk about ethics with the staff of a level‐three neonatal intensive care unit. They presented a case featuring a full‐term baby born by emergency caesarean‐section after a cord prolapse that caused…

Obstructive sleep apnea in a 17-year-old with profound cognitive impairment.

Rosen D, Wilfond B

For children with cognitive impairments who develop obesity and sleep apnea, the treatment options are not good. Adenotonsillectomy sometimes improves symptoms, but if it does not, then home continuous positive airway pressure (CPAP) is…

Marriage and the well-being of children.

Garrett JR

Children's well-being has become the focal consideration in legal and public policy debates regarding same-sex marriage. In this article, we critically examine and rebut the central moral argument made by opponents of same-sex marriage:…

Not Practicing What We Preach

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When Life-Sustaining Treatment Is Withdrawn and the Patient Doesn’t Die

Stefan Kutzsche, et al.

One of the most difficult decisions that doctors and parents must make is the decision to withdraw life-sustaining treatment. Doctors find it easier to withdraw treatments in situations where withdrawal will be rapidly fatal rather than in…

Learning the right lessons from the SUPPORT study controversy

Ten years ago, there was well-known and widespread practice variation in the levels of oxygen that neonatologists provided to premature babies.1 Neonatal intensive care units (NICUs) targeted oxygen saturations ranging from 82% to 100%.…

Does Data Shape Moral Decision? Or Do Values Shape the Data?

This paper examines the differences between different countries in policies regarding babies born at the borderline of viability. Such differences clearly exist. It is unclear whether they exist, in such an explicit way, for other…

Not practicing what we preach.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A Young Adult Jehovah’s Witness With Severe Anemia

Nnenna Ukachi, et al.

Two of the most ethically complex situations in pediatrics are those involving families whose religious beliefs preclude the provision of life-sustaining treatment and those involving young adults who have reached the age of legal majority…

Marriage and the Well-Being of Children

Jeremy R. Garrett

Children's well-being has become the focal consideration in legal and public policy debates regarding same-sex marriage. In this article, we critically examine and rebut the central moral argument made by opponents of same-sex marriage:…

Risks (and Benefits) in Comparative Effectiveness Research Trials

Chris Feudtner, Mark S. Schreiner

To provide ethically appropriate oversight and informed consent for randomized, controlled comparative effectiveness research trials, investigators should consider, manage, and inform potential participants about at least nine different…

A New Pediatrics for a New Century

Neil A. Ward

Is the field of pediatrics doing all that it can for the health of children? Many think that the field has gone off track and that we could do better. These articles highlight some different ways of judging the successes and failures of…

The Battle Lines of Sexual Politics and Medical Morality

Abstract One of two commentaries on “Normalizing Atypical Genitalia: How a Heated Debate Went Astray,” by Josephine Johnston, from the November‐December 2012 issue

Can a Patient Designate His Doctor as His Proxy Decision Maker?

Philip G. Black, et al.

Most lawyers and bioethicists recommend that patients enact a durable power of attorney for health care designating somebody as their proxy decision maker should they become unable to make decisions. Most people choose family members as…

The battle lines of sexual politics and medical morality.

Abstract One of two commentaries on “Normalizing Atypical Genitalia: How a Heated Debate Went Astray,” by Josephine Johnston, from the November‐December 2012 issue

When life-sustaining treatment is withdrawn and the patient doesn't die.

Kutzsche S, et al.

One of the most difficult decisions that doctors and parents must make is the decision to withdraw life-sustaining treatment. Doctors find it easier to withdraw treatments in situations where withdrawal will be rapidly fatal rather than in…

How do national guidelines frame clinical ethics practice? A comparative analysis of guidelines from the US, the UK, Canada and France

Nathalie Gaucher, Antoine Payot

International policies regulating clinical ethics committees' (CEC) roles are non-existent. Nonetheless, CECs have established themselves in several countries and there exist striking differences in the way these work. This international…

The OHRP and SUPPORT.

Wilfond BS, et al.

A group of medical ethicists and pediatricians asks for reconsideration of the recent Office for Human Research Protections decision about informed consent in

Vaccine Mandates Are Justifiable Because We Are All in This Together

Mary Anne Jackson

Influenza is a deadly disease. Every year, in the United States, 200,000 people are hospitalized with influenza and 23,000–33,000 people die of the disease (Heron 2008). Unimmunized health care

The Weird Divergence of Ethics and Regulation With Regard to Informed Consent

Click to increase image sizeClick to decrease image size Acknowledgments Conflict of interest: My employer, Children's Mercy Hospital (CMH), is currently a member of the NICHD Neonatal Research Network. CMH was not a member of the network…

The OHRP and SUPPORT

Benjamin S. Wilfond, et al.

A group of medical ethicists and pediatricians asks for reconsideration of the recent Office for Human Research Protections decision about informed consent in

A young adult Jehovah's Witness with severe anemia.

Ukachi N, et al.

Two of the most ethically complex situations in pediatrics are those involving families whose religious beliefs preclude the provision of life-sustaining treatment and those involving young adults who have reached the age of legal majority…

The weird divergence of ethics and regulation with regard to informed consent.

Click to increase image sizeClick to decrease image size Acknowledgments Conflict of interest: My employer, Children's Mercy Hospital (CMH), is currently a member of the NICHD Neonatal Research Network. CMH was not a member of the network…

Obstructive Sleep Apnea in a 17-Year-Old With Profound Cognitive Impairment

Dennis Rosen, Ben Wilfond

For children with cognitive impairments who develop obesity and sleep apnea, the treatment options are not good. Adenotonsillectomy sometimes improves symptoms, but if it does not, then home continuous positive airway pressure (CPAP) is…

Breastfeeding and complementary food: randomized trial of community doula home visiting.

Edwards RC, et al.

OBJECTIVES: Despite recent efforts to increase breastfeeding, young African American mothers continue to breastfeed at low rates, and commonly introduce complementary foods earlier than recommended. This study examines the effects of a…

Breastfeeding and Complementary Food: Randomized Trial of Community Doula Home Visiting

Renee C. Edwards, et al.

OBJECTIVES: Despite recent efforts to increase breastfeeding, young African American mothers continue to breastfeed at low rates, and commonly introduce complementary foods earlier than recommended. This study examines the effects of a…

A new pediatrics for a new century.

Ward NA

Is the field of pediatrics doing all that it can for the health of children? Many think that the field has gone off track and that we could do better. These articles highlight some different ways of judging the successes and failures of…

Vaccine mandates are justifiable because we are all in this together.

Jackson MA

Influenza is a deadly disease. Every year, in the United States, 200,000 people are hospitalized with influenza and 23,000–33,000 people die of the disease (Heron 2008). Unimmunized health care

Why money will not cure under-immunization

Societal attitudes about immunization are complex. Attitudes about the finances of immunization are, in some ways, even more

Risks (and benefits) in comparative effectiveness research trials.

Feudtner C, Schreiner M

To provide ethically appropriate oversight and informed consent for randomized, controlled comparative effectiveness research trials, investigators should consider, manage, and inform potential participants about at least nine different…

Why money will not cure under-immunization.

Societal attitudes about immunization are complex. Attitudes about the finances of immunization are, in some ways, even more

Newsflash: Pediatric Residency and Medical School Can't Teach Everything

Amber Hoffman, Denise Bratcher

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Modern Medicine Vs. The 12th Century

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethics and Decision Making in Neonatology

Annie Janvier, Keith J. Barrington

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Clinical ethical considerations in contraceptive care for teens.

Gowda SP

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Next-generation community genetics for low- and middle-income countries.

Kingsmore SF, et al.

A recent report by the World Health Organization calls for implementation of community genetics programs in low- and middle-income countries (LMICs). Their focus is prevention of congenital disorders and genetic diseases at the population…

Why we should eliminate personal belief exemptions to vaccine mandates.

Jackson MA, Harrison CJ

We argue that personal belief exemptions to the mandate for childhood immunizations should not be allowed. Parents who choose not to immunize their children put both their own children and other children at risk. Other children are at risk…

Health care professionals’ attitudes about pregnancy termination for different fetal anomalies

Annie Janvier, et al.

BACKGROUND: Health care professionals (HCPs) may be involved in counselling women after an antenatal diagnosis of various fetal anomalies. Many pregnant women consider termination of pregnancy (TOP) after antenatal diagnosis of various…

Ethics for the Pediatrician: The Evolving Ethics of Cochlear Implants in Children

The story of the ethical controversy over cochlear implants is unique in some ways and paradigmatic in others. It is unique in the ways that it was shaped by the history of deafness, and of cultural responses to deafness, in the United…

Pediatric Analgesic Clinical Trial Designs, Measures, and Extrapolation: Report of an FDA Scientific Workshop

Charles B. Berde, et al.

Analgesic trials pose unique scientific, ethical, and practical challenges in pediatrics. Participants in a scientific workshop sponsored by the US Food and Drug Administration developed consensus on aspects of pediatric analgesic clinical…

The nonimpact of gestational age on neurodevelopmental outcome for ventilated survivors born at 23–28 weeks of gestation

Bree Andrews, et al.

AIM: It has long been known that survival of preterm infants strongly depends upon birth weight and gestational age. This study addresses a different question - whether the gestational maturity improves neurodevelopmental outcomes for…

Justifiable and Unjustifiable Ageism

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Clinical Ethical Considerations in Contraceptive Care for Teens

Sonia P. Gowda

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A Baby With Meningococcemia and Septic Shock

Wendela G. Leeuwenburgh-Pronk, et al.

Sometimes a patient’s life can be saved but the price that must be paid, in terms of the burdens of treatment and the painful sequelae, can be considered too high. In this month’s “Ethics Rounds,” we present such a case from a Dutch ICU.…

A baby with meningococcemia and septic shock.

Leeuwenburgh-Pronk WG, et al.

Sometimes a patient’s life can be saved but the price that must be paid, in terms of the burdens of treatment and the painful sequelae, can be considered too high. In this month’s “Ethics Rounds,” we present such a case from a Dutch ICU.…

Case study. Confidentiality and its limits. Commentary.

Sonia Gowda

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Genomic medicine: evolving science, evolving ethics.

Soden SE, et al.

Genomic medicine is rapidly evolving. Next-generation sequencing is changing the diagnostic paradigm by allowing genetic testing to be carried out more quickly, less expensively and with much higher resolution; pushing the envelope on…

Should an IRB Approve a Placebo-Controlled Randomized Trial of Analgesia for Procedural Pain in Neonates?

Carlo V. Bellieni, et al.

Trial of Analgesia for Procedural Pain in Neonates?One of the most controversial issues in neonatology today is the appropriate treatment of procedural pain in the NICU.Infants in the NICU undergo numerous painful procedures.Policies and…

Justifiable and unjustifiable ageism.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Genomic Medicine: Evolving Science, Evolving Ethics

Sarah Soden, et al.

Genomic medicine is rapidly evolving. Next-generation sequencing is changing the diagnostic paradigm by allowing genetic testing to be carried out more quickly, less expensively and with much higher resolution; pushing the envelope on…

Testing children for adult-onset genetic diseases.

Caga-anan EC, et al.

* Abbreviations: AAP — : American Academy of Pediatrics APC — : adenomatous polyposis coli BRCA1 and BRCA2 — : breast cancer–associated genes 1 and 2 FAP — : familial adenomatous polyposis HBOC syndrome — : hereditary breast and…

Reading medical memoirs.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Rising preterm birth rates, 1989-2004: changing demographics or changing obstetric practice?

VanderWeele TJ, Lauderdale DS

Preterm birth rates are higher in the United States than in most industrialized countries, and have been rising steadily. Some attribute these trends to changing demographics, with more older mothers, more infertility, and more multiple…

Next-generation community genetics for low- and middle-income countries

Stephen F. Kingsmore, et al.

A recent report by the World Health Organization calls for implementation of community genetics programs in low- and middle-income countries (LMICs). Their focus is prevention of congenital disorders and genetic diseases at the population…

The Mathematics of Morality for Neonatal Resuscitation

William Meadow, et al.

This article discusses the ethical issues surrounding the resuscitation of infants who are at great risk to die or survive with significant morbidity. Data are introduced regarding money, outcomes, and prediction. Gestational age…

Ethical issues in neonatology

Recognize ways in which improved prenatal diagnosis may change neonatal care and may create additional ethical

Editors' Comments

William Meadow, et al.

We read with interest the ADV of Koletzko and colleagues, Paediatric Conferences: only a profit-making enterprise? In the words of former President Clinton, ‘we feel their pain’. However, we have some additional thoughts as well.…

Ethical Issues in Neonatal and Pediatric Clinical Trials

Naomi Laventhal, Beth A. Tarini

Children have been identified as uniquely vulnerable clinical research subjects since the early 1970s. This article reviews the historical underpinnings of this designation, the current regulatory framework for pediatric and neonatal…

Ethics for the pediatrician: the evolving ethics of cochlear implants in children.

The story of the ethical controversy over cochlear implants is unique in some ways and paradigmatic in others. It is unique in the ways that it was shaped by the history of deafness, and of cultural responses to deafness, in the United…

Reading Medical Memoirs

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Las equivocaciones en su contexto

Martha Montelo

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Re: ‘Decisions about life‐sustaining measures in children: in whose best interests?’

William Meadow

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Editors’ Comments

Joel Schwab, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The politics of probiotics: probiotics, necrotizing enterocolitis and the ethics of neonatal research

Annie Janvier, Keith J. Barrington

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethics for the Pediatrician

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. Implants all have four key components: (1) a microphone, which picks up…

Testing Children for Adult-Onset Genetic Diseases

E. Charlisse F. Caga-anan, et al.

* Abbreviations: AAP — : American Academy of Pediatrics APC — : adenomatous polyposis coli BRCA1 and BRCA2 — : breast cancer–associated genes 1 and 2 FAP — : familial adenomatous polyposis HBOC syndrome — : hereditary breast and…

The introduction of innovative technology into practice

Stories of clinical innovation in medicine are generally stories of fits and starts, of irrational exuberance and of avoidable tragedy, of skill, luck, science, and serendipity. Such stories are often transformed, in retrospect, into…

Dangerous and expensive screening and treatment for rare childhood diseases: The case of krabbe disease

Public policy surrounding newborn screening is in flux. New technology allows more screening for more diseases at lower cost. Traditional criteria for target diseases have been criticized by leading health policymakers. The example of…

Rising preterm birth rates, 1989–2004: Changing demographics or changing obstetric practice?

Tyler J. VanderWeele, Diane S. Lauderdale

Preterm birth rates are higher in the United States than in most industrialized countries, and have been rising steadily. Some attribute these trends to changing demographics, with more older mothers, more infertility, and more multiple…

Patient autonomy and the twenty-first century physician.

Garrett JR

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Dangerous and expensive screening and treatment for rare childhood diseases: the case of Krabbe disease.

Public policy surrounding newborn screening is in flux. New technology allows more screening for more diseases at lower cost. Traditional criteria for target diseases have been criticized by leading health policymakers. The example of…

In Reply

et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Should the “Slow Code” Be Resuscitated?

William Meadow

Most bioethicists and professional medical societies condemn the practice of "slow codes." The American College of Physicians ethics manual states, "Because it is deceptive, physicians or nurses should not perform half-hearted…

Re‐animating the ‘slow code’

William Meadow

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Conscience, clinical ethics, and emergency contraception.

Plantz D

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Should the "slow code" be resuscitated?

Meadow WL

Most bioethicists and professional medical societies condemn the practice of "slow codes." The American College of Physicians ethics manual states, "Because it is deceptive, physicians or nurses should not perform half-hearted…

The assessment of quality of life. Foreword.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Patient Autonomy and Clinician Integrity in Treatment Decisions—Reply

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Why We Should Eliminate Personal Belief Exemptions to Vaccine Mandates

Mary Anne Jackson, Christopher Harrison

We argue that personal belief exemptions to the mandate for childhood immunizations should not be allowed. Parents who choose not to immunize their children put both their own children and other children at risk. Other children are at risk…

Ethical considerations in pediatric BMT donors and recipients.

Kamani N, et al.

Just over 25 years ago, an 8-year-old girl with acute myelogenous leukemia (AML) who coincidentally had sickle cell disease (SCD) underwent a successful matched sibling donor bone marrow transplant (BMT) for her leukemia from her otherwise…

Agency and authenticity: Which value grounds patient choice?

Daniel Brudney

In current American medical practice, autonomy is assumed to be more valuable than human life: if a patient autonomously refuses lifesaving treatment, the doctors are supposed to let him die. In this paper we discuss two values that might…

What is Behind the Rising Rates of Preterm Birth in the United States?

Diane S. Lauderdale

We review three decades of unsuccessful efforts by public policy-makers in the United States to develop programs to lower the rate of preterm birth. We analyze why these efforts had been unsuccessful. Finally, we will speculate about…

Controversial Bodies

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The value of a trial of therapy – football as a ‘proof‐of‐concept’

William Meadow, et al.

Figure S1 Probability of winning if a team is leading at various times after kick off. Table S1 Outcomes of 115 professional football matches as a function of time Please note: The publisher is not responsible for the content or…

Conscience, Clinical Ethics, and Emergency Contraception

Diane M. Plantz

Emergency contraception (EC) is a generic term used to describe a group of hormonal methods taken within the first few days after unprotected sexual intercourse to prevent an unintended pregnancy. EC is safe and effective in preventing…

The Groningen Protocol

Eduard Verhagen

When Marieke was born, her pediatrician noticed skin erosions and blistering of the skin on all extremities. The lips and skin of her face showed raw red areas but otherwise she was vigorous and appeared healthy. She was transferred to a…

Clinician Integrity and Limits to Patient Autonomy

Ann Marie Matlock, David Wendler

A 28-year-old man with chronic granulomatous disease developed worsening respiratory status in the setting of chronic bacterial and fungal infections. The attending physician recommended transfer to the intensive care unit (ICU), but the…

Ethical considerations associated with clinical use of next-generation sequencing in children.

Artman M, Kingsmore SF

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Patient Autonomy and the Twenty‐First Century Physician

Jeremy R. Garrett

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Confidentiality and Its Limits

Maude Laliberté, Sonia Gowda

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Interface of Ethics and Palliative Care

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A “Narcotics Contract” for a Patient With Sickle Cell Disease and Chronic Pain

Carlton Dampier, Carlton Haywood

For many physicians, the treatment of chronic pain is one of the most difficult clinical and ethical challenges that they encounter. Patients with chronic pain can be demanding, frustrating, and mystifying. In pediatrics, sickle cell…

Ethical Considerations Associated with Clinical Use of Next-Generation Sequencing in Children

Michael Artman, Stephen F. Kingsmore

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Foreword

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Health Care Worker Knowledge, Attitudes, and Beliefs Regarding Mandatory Influenza Vaccination

Lauren Douville, et al.

OBJECTIVE: To determine the attitudes, beliefs, and knowledge of children's hospital health care workers toward mandatory influenza vaccination. DESIGN: Self-administered, Web-based questionnaire. SETTING: A large, tertiary children's…

It's Not the Growth Attenuation, It's the Sterilization!

The doctors and the hospital in the Ashley case made a major error. They should have sought a court order before proceeding with sterilization. Instead, they relied upon ethics committee review.

Current empirical research in neonatal bioethics.

Swinton CH

UNLABELLED: Ethical dilemmas in neonatology can be analysed using both the theoretical tools of analytic philosophy and the empirical tools of clinical epidemiology and health services research. Both yield important insights into ways to…

Ethical Considerations in Pediatric BMT Donors and Recipients

Naynesh Kamani, et al.

Just over 25 years ago, an 8-year-old girl with acute myelogenous leukemia (AML) who coincidentally had sickle cell disease (SCD) underwent a successful matched sibling donor bone marrow transplant (BMT) for her leukemia from her otherwise…

From the Editor New Clinical Powers, New Ethical Questions 775

George L. Anesi, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Very Sad and Scary Places

Very Sad and Scary Places John D. Lantos (bio) This Lovely Life: A Memoir of Premature Motherhood. By Vicki Forman. Mariner Books, 2009. 272 pages. $13.95. Paperback. Vicki Forman’s “memoir of premature motherhood” won top prize at the…

Pediatric Obesity, Statin Use, and the Goals of Medicine

Karen Uhlenhuth, Angira Patel

Prescribing statins for an overweight child’s high cholesterol could give both the patient and parents the wrong idea about what “healthy” really means. Virtual Mentor is a monthly bioethics journal published by the American Medical…

Overweight in Latino preschoolers: do parental health beliefs matter?

Kersey M, et al.

OBJECTIVE: To characterize the knowledge, attitudes, and beliefs (KAB) regarding childhood obesity among parents of Latino preschoolers. METHODS: Three hundred sixty-nine Mexican immigrant parents of children ages 2-5 were interviewed.…

Saturday morning postmortem.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Healthcare Worker Knowledge and Attitudes Regarding Influenza Immunization and Childhood Vaccination

Angela Myers, et al.

We surveyed healthcare workers (HCWs) about influenza vaccination and routine childhood vaccinations. We found that most HCWs' children received vaccinations, despite concerns regarding safety and efficacy. HCWs who received influenza…

On Cultural Sanctions for Shaping Our Children's Genitalia

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines Domain 8: Ethical and Legal Aspects of Care

William H. Colby, et al.

In 2001, leaders with palliative care convened to discuss the standardization of palliative care and formed the National Consensus Project for Quality Palliative Care. In 2004, the National Consensus Project for Quality Palliative Care…

Controversies in vaccine mandates.

et al.

Policies that mandate immunization have always been controversial. The controversies take different forms in different contexts. For routine childhood immunizations, many parents have fears about both short- and long-term side effects.…

To the Editor

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Current empirical research in neonatal bioethics

Cameron H Swinton

UNLABELLED: Ethical dilemmas in neonatology can be analysed using both the theoretical tools of analytic philosophy and the empirical tools of clinical epidemiology and health services research. Both yield important insights into ways to…

Screening Tests during Prenatal Care: Does Practice Follow the Evidence?

Juned Siddique, et al.

To examine whether the frequency of four screening tests during prenatal care conforms to evidence of effectiveness. We estimated rates of urine culture, anemia screening, oral glucose tolerance test (OGTT), and urinalysis during prenatal…

ICE volume 31 issue 6 Cover and Front matter

Umair Jabbar, et al.

An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action

Prenatal care utilization in excess of recommended levels: trends from 1985 to 2004.

Lauderdale DS, et al.

Indexes of prenatal care adequacy distinguish care that includes more than the recommended number of visits because extra visits may signal a high-risk pregnancy. Using Natality files from 1985 to 2004, the authors found such…

A Better Life through Science?

A Better Life through Science? John D. Lantos (bio) There is a moment in The Immortal Life of Henrietta Lacks that brought tears to my eyes. Henrietta Lacks is the woman whose cervical tumor gave rise to a cell line—brand named HeLa—that…

Historical trends in low birth weight.

Brosco JP, et al.

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Historical Trends in Low Birth Weight

Jeffrey P. Brosco, et al.

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Does Pediatrics Need Its Own Bioethics?

Pediatric bioethics raises unique issues because children are constantly growing, developing, and changing. The ethical issues that arise for newborns are different from those that arise for seven-year-olds or 17-year-olds. Furthermore,…

Conference Scene: Pediatric Pharmacogenomics and Personalized Medicine

J. Steven Leeder, Stephen P. Spielberg

A major challenge for clinicians, pharmaceutical companies and regulatory agencies is to better understand the relative contributions of ontogeny and genetic variation to observed variability in drug disposition and response across the…

Overweight in Latino Preschoolers: Do Parental Health Beliefs Matter

Margaret Kersey, et al.

OBJECTIVE: To characterize the knowledge, attitudes, and beliefs (KAB) regarding childhood obesity among parents of Latino preschoolers. METHODS: Three hundred sixty-nine Mexican immigrant parents of children ages 2-5 were interviewed.…

Health care worker knowledge, attitudes, and beliefs regarding mandatory influenza vaccination.

Douville LE, et al.

OBJECTIVE: To determine the attitudes, beliefs, and knowledge of children's hospital health care workers toward mandatory influenza vaccination. DESIGN: Self-administered, Web-based questionnaire. SETTING: A large, tertiary children's…

Controversies in Vaccine Mandates

et al.

Policies that mandate immunization have always been controversial. The controversies take different forms in different contexts. For routine childhood immunizations, many parents have fears about both short- and long-term side effects.…

Book Review Complex Ethics Consultations: Cases That Haunt Us Edited by Paul J. Ford and Denise M. Dudzinski. 251 pp. New York, Cambridge University Press, 2008. $60. 978-0-521-69715-6

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Curious Case of Ashley X

Kristi L. Kirschner, et al.

In October 2006, Gunther and Diekema [1] published the article “Attenuating growth in children with profound developmental disability” in the Archives of Pediatric and Adolescent Medicine, which set off a firestorm of controversy. The…

Trends in Prenatal Ultrasound Use in the United States

Juned Siddique, et al.

BACKGROUND: While controversy continues about the appropriateness of routine ultrasound screening, there are little data on actual clinical practices or trends in the United States. OBJECTIVES: To examine changes in prenatal ultrasound…

It Is Time to Professionalize Institutional Review Boards

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Hot Debate About a Cool Therapy

William Meadow

The status of hypothermia as a treatment for perinatal asphyxia remains controversial. This review examines recent studies and professional opinions about whether this treatment should be considered “experimental” or “standard” and places…

Trends in prenatal ultrasound use in the United States: 1995 to 2006.

Siddique J, et al.

BACKGROUND: While controversy continues about the appropriateness of routine ultrasound screening, there are little data on actual clinical practices or trends in the United States. OBJECTIVES: To examine changes in prenatal ultrasound…

Moral Reflections on Neonatal Intensive Care

William Meadow

In this issue of Pediatrics, Itabashi et al1 report survival statistics for infants at 22 weeks' gestation born in Japan. The most striking finding is that their survival rate was much better than that reported anywhere else in the world…

Reflexiones éticas sobre los cuidados intensivos neonatales

William Meadow

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Prenatal Care Utilization in Excess of Recommended Levels: Trends From 1985 to 2004

Diane S. Lauderdale, et al.

Indexes of prenatal care adequacy distinguish care that includes more than the recommended number of visits because extra visits may signal a high-risk pregnancy. Using Natality files from 1985 to 2004, the authors found such…

Paediatrics-based fetal care: unanswered ethical questions.

Brown SD, et al.

http://dx.doi.org/10.1111/j.1651-2227.2008.01070.x

Religion, conscience and clinical decisions.

Curlin FA

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Religion, conscience and clinical decisions

Farr A. Curlin

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

In reply [12]

Alexia M. Torke, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Four Recent Health Reform Initiatives

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Physicians and Decision Making in Dementia—Reply

Alexia M. Torke, et al.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications…

Substituted Judgment: The Limitations of Autonomy in Surrogate Decision Making

Alexia M. Torke, G. Caleb Alexander

Substituted judgment is often invoked as a guide for decision making when a patient lacks decision making capacity and has no advance directive. Using substituted judgment, doctors and family members try to make the decision that the…

Neonatal Bioethics

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Nuances of Self-disclosure

G. Caleb Alexander

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Ethics ain't easy: do we need simple rules for complicated ethical decisions?

Annie Janvier, et al.

BACKGROUND: Recommendations from national bodies regarding extremely preterm infants have focussed almost exclusively on thresholds for intervention based upon estimated gestational age (GA) alone. METHODS: We reviewed policy statements…

Ethical and Legal Issues for the Primary Care Physician

Lainie Friedman Ross

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Four recent health reform initiatives: implications for pediatric health reform.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA…

Letter to the Editor

Alexia M. Torke, G. Caleb Alexander

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Paediatrics‐based fetal care: unanswered ethical questions

Stephen D. Brown, et al.

http://dx.doi.org/10.1111/j.1651-2227.2008.01070.x

Should testing for BRCA1/2 mutations be permitted in children?

Angela R. Bradbury

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Relationship Between Site of Training and Residents' Attitudes About Neonatal Resuscitation

Annie Janvier, et al.

OBJECTIVE: To determine whether the attitudes of pediatric and obstetric residents concerning the resuscitation of extremely preterm infants, and their knowledge of outcomes, varies according to their center of training and its…

Research in Wonderland: Does “Minimal Risk” Mean Whatever an Institutional Review Board Says It Means?

"Research in Wonderland: Does “Minimal Risk” Mean Whatever an Institutional Review Board Says It Means?." The American Journal of Bioethics, 7(3), pp.

Religion, Conscience, and Morally Controversial Clinical Practices: Results from a National Physician Survey

Farr A. Curlin, et al.

Restricted accessAbstractFirst published March 2007Religion, Conscience, and Morally Controversial Clinical Practices: Results from a National Physician SurveyF.A. Curlin, R. Lawrence, […], M.H. Chin, and J.D. Lantos+1-1View all authors…

The Edge Of The Known World

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Relationship Between Psychiatry and Religion Among U.S. Physicians

Farr A. Curlin, et al.

OBJECTIVE: This study compared the religious characteristics of psychiatrists with those of other physicians and explored whether nonpsychiatrist physicians who are religious are less willing than their colleagues to refer patients to…

Parents Who Walk Away

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Research in wonderland: does "minimal risk" mean whatever an institutional review board says it means?

"Research in Wonderland: Does “Minimal Risk” Mean Whatever an Institutional Review Board Says It Means?." The American Journal of Bioethics, 7(3), pp.

Should Institutional Review Board Decisions Be Evidence-Based?

Taneja et al1 introduce their excellent and rigorous study on the stresses experienced by parents who are asked to participate in research about their recently deceased children by noting the

Religion, Conscience, and Controversial Clinical Practices

Farr A. Curlin, et al.

BACKGROUND: There is a heated debate about whether health professionals may refuse to provide treatments to which they object on moral grounds. It is important to understand how physicians think about their ethical rights and obligations…

Do Religious Physicians Disproportionately Care for the Underserved?

Farr A. Curlin, et al.

PURPOSE: Religious traditions call their members to care for the poor and marginalized, yet no study has examined whether physicians' religious characteristics are associated with practice among the underserved. This study examines whether…

Religion, Spirituality, and Medicine: Psychiatrists’ and Other Physicians’ Differing Observations, Interpretations, and Clinical Approaches

Farr A. Curlin, et al.

OBJECTIVE: This study compared the ways in which psychiatrists and nonpsychiatrists interpret the relationship between religion/spirituality and health and address religion/spirituality issues in the clinical encounter. METHOD: The authors…

The relationship between psychiatry and religion among U.S. physicians.

Curlin FA, et al.

OBJECTIVE: This study compared the religious characteristics of psychiatrists with those of other physicians and explored whether nonpsychiatrist physicians who are religious are less willing than their colleagues to refer patients to…

The Physician-Surrogate Relationship

Alexia M. Torke, et al.

The physician-patient relationship is a cornerstone of the medical encounter and has been analyzed extensively. But in many cases, this relationship is altered because patients are unable to make decisions for themselves. In such cases,…

The edge of the known world.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Neonatology has always been a bargain – even when we weren't very good at it!

Basharat Buchh, et al.

OBJECTIVE: We wondered whether Neonatal Intensive Care Unit resources for Extremely Low Birth Weight infants have always been disproportionately devoted to survivors, even when ELBW infants were very likely to die. METHODS: We documented…

At the Lok Nayak Hospital, Delhi

At the Lok Nayak Hospital, Delhi John D. Lantos (bio) To travel by auto-rickshaw through New Delhi is to understand the profound truths of the Yom Kippur liturgy, "Man's origin is dust and dust is his end, each of us is a shattered urn,…

Are Newborns Morally Different from Older Children?

Annie Janvier, Karen Lynn Bauer

Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and…

Religion, spirituality, and medicine: psychiatrists' and other physicians' differing observations, interpretations, and clinical approaches.

Curlin FA, et al.

OBJECTIVE: This study compared the ways in which psychiatrists and nonpsychiatrists interpret the relationship between religion/spirituality and health and address religion/spirituality issues in the clinical encounter. METHOD: The authors…

Moral distress and ethical confrontation: problem or progress?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

At the Lok Nayak Hospital, Delhi.

At the Lok Nayak Hospital, Delhi John D. Lantos (bio) To travel by auto-rickshaw through New Delhi is to understand the profound truths of the Yom Kippur liturgy, "Man's origin is dust and dust is his end, each of us is a shattered urn,…

Physicians' observations and interpretations of the influence of religion and spirituality on health.

Curlin FA, et al.

BACKGROUND: In spite of a substantial body of empirical data, professional disagreement persists regarding whether and how religion and spirituality (hereinafter "R/S" and treated as a single concept) influences health. This study examines…

Sherwin B. Nuland. Maimonides. New York, Schocken, 2005. xiii, 223 pp. $19.95 (paper)

Sherwin Nuland's book, Maimonides, is part of a series of books published by an organization called Nextbook. Nextbook, according to its website, is “created as a locus for Jewish literature, culture, and ideas.” Among other activities…

Review of Ruth Levy Guyer.Babyat Risk: The Uncertain Legacies of Medical Miracles for Babies, Families, andSociety1

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Religion, conscience, and controversial clinical practices.

Curlin FA, et al.

BACKGROUND: There is a heated debate about whether health professionals may refuse to provide treatments to which they object on moral grounds. It is important to understand how physicians think about their ethical rights and obligations…

General Pediatricians' Views on Allocating More Time in Primary Care Practice to Children with Special Health Care: Results from a National Survey

Tumaini R. Coker, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

6 RELIGION, CONSCIENCE, AND MORALLY CONTROVERSIAL CLINICAL PRACTICES: RESULTS FROM A NATIONAL PHYSICIAN SURVEY.:

Farr A. Curlin, et al.

<h3>Background</h3> Guidelines recommend 10-day treatment courses for acute sore throat, but shorter courses may be used in practice. <h3>Aim</h3> To determine whether antibiotic duration predicts adverse outcome of acute sore throat in…

The doctor-patient relationship in the post-managed care era.

Alexander GC

The growth of managed care was accompanied by concern about the impact that changes in health care organization would have on the doctor-patient relationship (DPR). We now are in a "post-managed care era," where some of these changes in…

Commentary: Physicians as Public Servants in the Setting of Bioterrorism

G. Caleb Alexander

Physicians have special professional obligations to respond to medical emergencies. A bioterrorism attack would be a medical emergency. Thus, it seems that physicians would have an obligation to respond to a bioterrorist attack. However,…

Summary Proceedings From the Neonatal Pain-Control Group

K.J.S. Anand, et al.

Recent advances in neurobiology and clinical medicine have established that the fetus and newborn may experience acute, established, and chronic pain. They respond to such noxious stimuli by a series of complex biochemical, physiologic,…

Innovation in Human Research Protection: The AbioCor Artificial Heart Trial

E. Haavi Morreim, et al.

Click to increase image sizeClick to decrease image size Notes 1. As a matter of semantic housekeeping, this article will not dwell on the choice of terms between patient, subject, volunteer, participant, or other terms referring to people…

Rethinking Professional Ethics in the Cost-Sharing Era

G. Caleb Alexander, Mark A. Hall

Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care…

The Association of Physicians’ Religious Characteristics With Their Attitudes and Self-Reported Behaviors Regarding Religion and Spirituality in the Clinical Encounter

Farr A. Curlin, et al.

CONTEXT: Controversy exists regarding whether and how physicians should address religion/spirituality (R/S) with patients. OBJECTIVE: This study examines the relationship between physicians' religious characteristics and their attitudes…

Rethinking professional ethics in the cost-sharing era.

Alexander GC, Hall MA

Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care…

The association of physicians' religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter.

Curlin FA, et al.

CONTEXT: Controversy exists regarding whether and how physicians should address religion/spirituality (R/S) with patients. OBJECTIVE: This study examines the relationship between physicians' religious characteristics and their attitudes…

Educational Approaches to the Responsible Conduct of Clinical Research: An Exploratory Study

Debra DeBruin, et al.

PURPOSE: To identify best practices in education related to the responsible conduct of clinical research (RCCR). METHOD: American Society for Bioethics and Humanities (ASBH) members involved with teaching RCCR were asked to complete an…

Innovation in human research protection: the AbioCor artificial heart trial.

Morreim EH, et al.

Click to increase image sizeClick to decrease image size Notes 1. As a matter of semantic housekeeping, this article will not dwell on the choice of terms between patient, subject, volunteer, participant, or other terms referring to people…

When parents request seemingly futile treatment for their children.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Reducing Home Triggers for Asthma: The Latino Community Health Worker Approach

Molly A. Martin, et al.

This study assessed the ability of a community health worker asthma intervention to change home asthma triggers. A total of 56 children and 47 adults with asthma were enrolled. Home trigger scores for the children averaged 2.8 at the…

Should Our Well-Child Care System Be Redesigned? A National Survey of Pediatricians

Tumaini R. Coker, et al.

OBJECTIVE: The goal was to examine pediatricians' views about whether and how well-child care for children 0 to 5 years of age should be changed. METHODS: A mail survey of a national random sample of 1000 general pediatricians was…

The Doctor-Patient Relationship in the Post-Managed Care Era

G. Caleb Alexander

The growth of managed care was accompanied by concern about the impact that changes in health care organization would have on the doctor-patient relationship (DPR). We now are in a "post-managed care era," where some of these changes in…

Soutenir le professionnalisme: Miser sur les désaccords entre les résidents et les médecins traitants

G. Caleb Alexander, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Shoring up professionalism. Building on disagreements between residents and attending physicians.

G. Caleb Alexander, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Sociobiology of Humanism

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethics class.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

When patients choose faith over medicine: physician perspectives on religiously related conflict in the medical encounter.

Curlin FA, et al.

BACKGROUND: Patients at times disagree with medical recommendations for religious reasons. Despite a lively debate about how physicians should respond to patients' religious concerns, little is known about how physicians actually respond.…

How are religion and spirituality related to health? A study of physicians' perspectives.

Curlin FA, et al.

BACKGROUND: Despite expansive medical literature regarding spirituality and medicine, little is known about physician beliefs regarding the influence of religion on health. METHODS: Semistructured interviews with 21 physicians regarding…

Ethics Class

Ethics Class John Lantos (bio) In our medical school, we teach ethics during the first year. We try to make it interesting by bringing in clinicians to discuss cases. Medical students do not like theory. Like William Carlos Williams, they…

Religious characteristics of U.S. physicians: a national survey.

Curlin FA, et al.

BACKGROUND: Patients' religious commitments and religious communities are known to influence their experiences of illness and their medical decisions. Physicians are also dynamic partners in the doctor-patient relationship, yet little is…

Analgesia and anesthesia for neonates: Study design and ethical issues

K.J.S. Anand, et al.

OBJECTIVE: The purpose of this article is to summarize the clinical, methodologic, and ethical considerations for researchers interested in designing future trials in neonatal analgesia and anesthesia, hopefully stimulating additional…

How Are Religion and Spirituality Related to Health? A Study of Physicians’ Perspectives

Farr A. Curlin, et al.

BACKGROUND: Despite expansive medical literature regarding spirituality and medicine, little is known about physician beliefs regarding the influence of religion on health. METHODS: Semistructured interviews with 21 physicians regarding…

Improving Asthma Research in an Inner-City Latino Neighborhood with Community Health Workers

Molly A. Martin, et al.

This study tests the feasibility of a partnership between an academic medical center and community health workers to perform mutually beneficial research investigating asthma in an urban Latino neighborhood. Community heath workers…

When Patients Choose Faith Over Medicine

Farr A. Curlin, et al.

BACKGROUND: Patients at times disagree with medical recommendations for religious reasons. Despite a lively debate about how physicians should respond to patients' religious concerns, little is known about how physicians actually respond.…

Commentary on “A Draft Model Aggregated Code for Bioethicists”

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

In Practice: Ethics Class

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Commentary on "A draft model aggregated code for bioethicists".

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Evaluation of a Latino Community Health Worker HIV Prevention Program

Molly A. Martin, et al.

This study evaluated the effectiveness of a community health promotion project to increase HIV knowledge in an urban, immigrant Latino community in Chicago. Latino participants (N = 704) answered questions on HIV before and after an…

Breast-feeding History and Overweight in Latino Preschoolers

Margaret Kersey, et al.

OBJECTIVE: Describe the relationship between breast-feeding history and risk of overweight in the preschool years in a sample of primarily Mexican-origin Latinos. METHODS: Children's breast-feeding history, health history, and…

Breast-feeding history and overweight in Latino preschoolers.

Kersey M, et al.

OBJECTIVE: Describe the relationship between breast-feeding history and risk of overweight in the preschool years in a sample of primarily Mexican-origin Latinos. METHODS: Children's breast-feeding history, health history, and…

Religious characteristics of U.S. physicians

Farr A. Curlin, et al.

BACKGROUND: Patients' religious commitments and religious communities are known to influence their experiences of illness and their medical decisions. Physicians are also dynamic partners in the doctor-patient relationship, yet little is…

Changes in Mortality for Extremely Low Birth Weight Infants in the 1990s: Implications for Treatment Decisions and Resource Use

William Meadow, et al.

OBJECTIVE: Much has changed in neonatal intensive care unit (NICU) care over the past decade. High-frequency oscillation, inhaled nitric oxide, and antenatal corticosteroids are now widely available. We wondered how these medical advances…

In Practice: Just Visiting

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Pediatric research: what is broken and what needs to be fixed?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Consulting the Many and the Wise

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Book of Jesse: A Story of Youth, Illness, and Medicine

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Who Cares for the Children? Pediatricians and Parental Leave

Craig F. Garfield, et al.

CONTEXT: Evidence suggests that parental leave (PL) benefits child health and infant-parent attachment, yet little is known about how pediatricians view and discuss PL with parents. OBJECTIVE: To determine pediatricians' attitudes,…

RVUs Blues: How Should Docs Get Paid?

It has become increasingly difficult to place a value on the work that doctors do. Yet fiscal pressures have lead to economic incentives for performing certain kinds work instead of others. So the question arises: what are the ethics and…

Current opinion in pediatrics: ethics and law 2001

William Meadow, Ann Dudley Goldblatt

Meadow, William MD, PhD*†; Goldblatt, Ann Dudley JD†; Lantos, John MD*† Author

Youth Targeting By Tobacco Manufacturers Since The Master Settlement Agreement

Paul J. Chung, et al.

The 1998 Master Settlement Agreement (MSA) between tobacco manufacturers and forty-six states bans manufacturers from targeting minors through advertising. To determine how youth targeting in magazine cigarette advertisements changed after…

Which Nurseries Currently Care for Ventilated Neonates in Illinois and Wisconsin? Implications for the Next Generation of Perinatal Regionalization

William Meadow, et al.

We were interested in the extent to which advances in the availability of neonatalogy expertise have provided a centrifugal impetus to perinatal care. Specifically, we wondered where infants who were sick enough to require mechanical…

Somebody Will Pay: Presented as the Melinda A. Pouncey Memorial Lectureship, "Ethical Issues in Neonatal Intensive Care," at Ochsner Clinic and Alton Ochsner Medical Foundation, November 8, 2000. It is based on the first chapter of the author's forthcoming book, A Tiny Baby in a Court of Law.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Hooked On Neonatology

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Medical Ethics through the Star Trek Lens

James J. Hughes

Literature and Medicine - Volume 20, Number 1, Spring

The Physician's Novelist

David Brown, Carl Elliott

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Confessions of a Medicine Man: An Essay in Popular Philosophy (review)

Perspectives in Biology and Medicine - Volume 44, Number 1, Winter

Hooked on neonatology.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Witches, Pubertal Development, and "Minimal Risk"

Debjani Mukherjee

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Disclosing the Diagnosis of HIV in Pediatrics

Erin Flanagan-Klygis, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Growth hormone therapy for Prader-Willi and Down syndromes: A post-modern medical dilemma

Post-modernism means the end of traditional certainties. In this paper, growth hormone (GH) is conceptualized as a post-modern medical therapy. It is used in the treatment of conditions that are not traditional diseases, for indications…

Program description for the exposure to violence program

Amy Lynn Davies

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Open Heart [Shiva M'Hodu]

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethical considerations in the public policy laboratory.

Davis MM

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open…

To tell or not to tell: must the doctors inform her she'll be infertile?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Growth hormone therapy for Prader-Willi and Down syndromes: a post-modern medical dilemma.

Post-modernism means the end of traditional certainties. In this paper, growth hormone (GH) is conceptualized as a post-modern medical therapy. It is used in the treatment of conditions that are not traditional diseases, for indications…

The Physician as a Health Care Proxy

Arti Rai, Mark Siegler

Many states prohibit patients from appointing their physicians as health care proxies, fearing paternalism and conflict of interest. But the potential for conflict is not unique to physicians, and patients may have compelling reasons to…

Reconsidering Action: Day-to-Day Ethics in the Work of Medicine

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Reconsidering action: day-to-day ethics in the work of medicine.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The “inclusion benefit” in clinical trials

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Why Doctors Make Good Protagonists

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Epidemiology and Ethics in the Neonatal Intensive Care Unit

William Meadow

There are many ethical dilemmas in the neonatal intensive care unit (NICU), and almost as many solutions as dilemmas. Religion, philosophy, natural law, civil law, criminal law, to name but a few, have each been invoked as a source of…

Negotiating Neonatal Deaths - Bioethical Dreams and Emotional Realities

Zaiga Robins, William Meadow

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Afterword

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Centrifugal Spread of Neonatal Intensive Care in the Midwest: March of Progress or Runaway Train?

Anthony Bell, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

AMJ volume 25 issue 4 Cover and Front matter

Jon Westling, et al.

An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action

Afterword:

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The "inclusion benefit" in clinical trials.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Two Models of Perinatal Regionalization: One fashionable, Both Functional? † 1280

Mi Jung Kim, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

A Proactive, Data-based Determination of the Standard of Medical Care in Pediatrics

William Meadow

A 3-week-old infant awoke with a fever. He was taken to the doctor who noted that the child was irritable. The doctor took him to the hospital where a resident performed a spinal tap, started an intravenous (IV) line, and ordered…

Am I My Brother's Keeper? The Ethical Frontiers of Biomedicine By Arthur L. Caplan (review)

to her doctor hadn't. If anything, in the final stages of illness, her need for his human empathy , his care, his interest in her, if not for his encouragement, was stronger than ever at the very point when he had disappeared. In her last…

The Authority of the Clinical Ethicist

David Casarett, Frona Daskal

Mediator? Moral Expert? Or both? "Discourse Ethics" suggests that consensus provides the foundation for defensible moral norms. Thus in building consensus on a moral problem, an ethicist is not just negotiating a compromise but is…

Aggression and violence directed toward physicians

Jeanette Morrison, Wendy Levinson

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Have we treated AIDS too well? Rationing and the future of AIDS exceptionalism.

Casarett DJ

During the past decade, medical therapy for AIDS has become more effective but also prohibitively expensive. A medical tragedy has been transformed into a financial crisis, and society has responded by establishing special programs and…

Aggression and violence directed toward physicians.

Morrison JL, Levinson W

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Against The Spirit of System: The French Impulse in Nineteenth Century American Medicine By John Harley Warner (review)

Against The Spirit ofSystem: TheFrench Impulse in Nineteenth Century American Medicine . By John Harley Warner. Princeton: Princeton UP, 1998. Pp. 510. $49.50. John Harley Warner's book, Against the Spirit ofSystem: The French Impube in…

Primum non nocere today

G. R. Burgio

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century by Joel Howell (review)

tions. James Neel unknowingly prepared for an event that was not supposed to happen: atomic bombs exploding over two major cities. The possible effects oflongterm radiation on a large human population in or near Chernobyl's fallout will…

Physicians’ Experience With Allegations of Medical Malpractice in the Neonatal Intensive Care Unit

William Meadow, Anthony Bell

OBJECTIVE: To assess the personal experience of all practitioners of neonatal intensive care unit (NICU) medicine in the United States with the medical malpractice system; in particular, to assess the circumstances of malpractice…

We asked Dr Lantos to respond to this piece by Malcontent: Was the UK Collaborative ECMO trial ethical?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Resource Allocation in Neonatal and Medical ICUs

Mani Mokalla, William Meadow

This study compared resource allocation to patients who eventually die in neonatal ICUs (NICUs) and adult medical ICUs (MICUs). It was performed via retrospective, chart review study at ICUs at the University of Chicago-an inner city,…

Resource allocation in neonatal and medical ICUs. Epidemiology and rationing at the extremes of life.

Mokalla M, Meadow W

This study compared resource allocation to patients who eventually die in neonatal ICUs (NICUs) and adult medical ICUs (MICUs). It was performed via retrospective, chart review study at ICUs at the University of Chicago-an inner city,…

Community Equipoise and the Architecture of Clinical Research

Jason Karlawish

We have argued for a revision of Freedman's concept of clinical equipoise to a broader sense of community that includes physicians and patients. Community equipoise is an essential condition for physicians and patients to answer these…

Was the UK collaborative ECMO trial ethical?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The Relationship Between Physician Behaviors and Blood Gas Values in the First Hours of Life-Implications For “Standards” of Medical Care for Infants with Respiratory Distress

William Meadow, et al.

It is standard practice for physicians to use blood gas (BG) evaluations when evaluating neonates with respiratory distress. In this study we addressed two questions: (1) What is the distribution of BG values in a population of infants…

Reassessing medical studentsʼ willingness to treat HIV-infected patients

D Carter, Jeff Hughes

BACKGROUND: Past research has demonstrated that some physicians do not feel obligated to care for patients infected with the human immunodeficiency virus (HIV). This study sought to characterize the attitudes that affect medical students'…

Expert Testimony, Legal Reasoning, and Justice

William Meadow

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Distributive Justice Across Generations

William Meadow, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Stories of Biology and Medicine

Richard Powers

The Novels of Richard Powers The Gold Bug Variations Operation Wandering Soul Galatea

Seeking Justice for Priscilla

I am currently caring for a child named Priscilla who is ventilator-dependent and whose care confronted me with questions of justice. Priscilla was born at the County Hospital after a normal pregnancy to a 17-year-old single mother. At…

Can and Should Level II Nurseries Care for Newborns Who Require Mechanical Ventilation?

William Meadow, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Should We Always Tell Children the Truth?

SHOULD WE ALWAYS TELL CHILDREN THE TRUTH! JOHN D. LANTOS* Truth-telling, in medicine, is a peculiar cultural artifact. In America, we seem to endorse it more than most doctors in most other places, and today we endorse it more than ever…

Distributive justice across generations. Epidemiology of ICU care for the very young and the very old.

Meadow W, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Birth Weight-specific Mortality for Extremely Low Birth Weight Infants Vanishes by Four Days of Life: Epidemiology and Ethics in the Neonatal Intensive Care Unit

William Meadow, Tyler Reimshisel

BACKGROUND: The persistent differences between those who question the appropriateness of aggressive resuscitative measures for many extremely low birth weight (ELBW) infants (birth weight < 1001 g) and those who generally initiate such…

Immunisation against chickenpox.

Ross LF

fasciotomy.Better demarcation of non-viable tissue makes for precise debridement, and only at this stage may discrimina- tion between a potentially salvageable and an irretrievably damaged limb become clear.Restoration of skeletal…

Immunisation against chickenpox: Authors’ reply.

Lainie Friedman Ross

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Immunisation against chickenpox

L. F. Ross

fasciotomy.Better demarcation of non-viable tissue makes for precise debridement, and only at this stage may discrimina- tion between a potentially salvageable and an irretrievably damaged limb become clear.Restoration of skeletal…

Authors' reply

L. F. Ross

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Withholding and withdrawing life sustaining treatment in neonatal intensive care: issues for the 1990s.

et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Primum Non Nocere Today a Symposium on Pediatric Bioethics : Proceedings of the International Symposium on Pediatric Bioethics, Pavia, 26-28 May 1994

G. R. Burgio

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethics committees and resource allocation.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Ethics, randomization, and technology assessment

Randomized controlled trials raise a number of ethical issues. Physicians who participate in such trials must be in a state of "equipoise," or genuine uncertainty about the relative merits of the two arms of the trial. Otherwise, they…

Ethical issues. How can we distinguish clinical research from innovative therapy?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Peter pan, the pied piper and pediatrics

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Overtreatment of neonates.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Overtreatment of Neonates

To the Editor.— At a recent meeting of the Society for Pediatric Research, Tyson et al presented an algorithm that correctly predicted outcome or could correctly predict outcome for 78% to 85% of infants.1 A subset of infants could be…

Informed consent the whole truth for patients?

Two misconceptions about informed consent concern the difference between the legal and moral justification for it, and the rationale for more rigorous consent for research than for "standard" therapy. Legally, informed consent for therapy…

The impact of clinical trial protocols on patient care system

Walter Lawrence, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Do-not-resuscitate orders in a childrenʼs hospital

ADAM C. BERGER, Aaron R. Zucker

OBJECTIVES: a) To quantify the use of do-not-resuscitate orders in a tertiary care children's hospital; and b) to characterize the circumstances in which such orders are written. DESIGN: Retrospective chart review. SETTING: University…

Sample Size: Profound Implications of Mundane Calculations

Controversies in the design of clinical trials excite a small but feisty group of academicians. On one side of the controversy is a group I call the "rigorists," who argue that clinical medicine must be based only on facts that are…

Sample size: profound implications of mundane calculations.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The ethical treatment of cancer what is right for the patient?

Judith Prestifilippo, et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

The case. What should Leah be told?

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Do-not-resuscitate orders in a children's hospital.

Berger AC, Zucker AR

OBJECTIVES: a) To quantify the use of do-not-resuscitate orders in a tertiary care children's hospital; and b) to characterize the circumstances in which such orders are written. DESIGN: Retrospective chart review. SETTING: University…

Clinical Trials and P Values

In Reply.— Here is the question: Are randomized trials so superior to other knowledge-generating techniques that we should not consider a fact to have been established unless it has been established by such a trial? If so, then the use of…

Ethical Aspects of Pediatric Home Care

Arthur F. Kohrman

This essay is a discussion of ethical issues that arise in the provision of home health care to technology-dependent children. Different ethical norms, especially with regard to the degree of professional responsibility for outcomes,…

Providing and forgoing resuscitative therapy for babies of very low birth weight.

et al.

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Commentary: Liver-Donors Liver Transplants

James F. Blumstein, et al.

An abstract is not available for this content so a preview has been provided. Please use the Get access link above for information on how to access this

Providing and Forgoing Resuscitative Therapy for Babies of Very Low Birth Weight

et al.

We compared practices at three different NICUs and tried to determine\nwhether physicians' practices regarding the use or withholding of\nresuscitative therapy were consistent from one hosptial to another. \nResuscitation practices…

Ethical aspects of pediatric home care.

Kohrman AF

Peer-reviewed publication from the Lantos bibliography. Open the venue link for the full text.

Scientific and ethical consequences of disease prediction

Mark Siegler, Stephanie A. Amiel

HLA-typing, gene analysis, anti-islet cell antibody testing and metabolic studies can identify people at high risk for developing Type 1 (insulin-dependent) diabetes mellitus prior to the onset of clinical disease. The positive predictive…

What Is the Legal `Standard of Medical Care' When There Is No Standard Medical Care? A Survey of the Use of Home Apnea Monitoring by Neonatology Fellowship Training Programs in the United States

William Meadow, et al.

In treating a patient, a doctor is obliged to use the skill and care that is ordinarily used by reasonably well-qualified doctors in similar cases. In addition, the only way in which a juror may decide whether the defendant used the skill…

Pediatric Bioethics

Why the Dutch Keep Pediatric Euthanasia Illegal

Associations of Physician Perspectives, Personal Choices, and Counseling for Severe Congenital Heart Defects

Variation in the extent to which patient information leaflets describe potential benefits and harms of trial interventions: a commentary

Pediatric Gender Medicine—Reply

The Philosophical Fiction of Substituted Judgment

Variation in the extent to which patient information leaflets describe potential benefits and harms of trial interventions: a commentary.

Toward Evidence-Based and Ethical Pediatric Gender Medicine

The Philosophical Fiction of Substituted Judgment.

Associations of Physician Perspectives, Personal Choices, and Counseling for Severe Congenital Heart Defects.

IVF, Culture Wars, and &quot;Joy&quot;

Research in Gender Medicine Sucks

Imane Khalif and Eero Mäntyranta

Whistleblowing: A Special Sort of Hell

Is Comstock Coming for your Condoms?

Shortcomings of Citizen Science

Gaza and the complexity and context of suffering.

Gaza and the complexity and context of suffering

The slow, necessary growth of pediatric palliative care.

Abortion as a human right’

How to move forward in shared decision-making in pediatric palliative care

How Will Medicare Negotiate Drug Prices, And What Impact Will It Have?

The slow, necessary growth of pediatric palliative care

The Dutch model for regulating paediatric euthanasia

Texas Abortion Decision

Suppressing free speech as a form of free speech?

I dare you: Read these two books together.

Gender-affirming treatment: life-saver or child-abuse

Who should debate RFK Jr?

Drama about Duchenne at the FDA

Is Pregnancy A Disease?

Trans politics brings down PM Sturgeon

Understanding the Clinical Utility of Genome Sequencing in Critically Ill Newborns.

Challenges in accelerated approvals for gene therapies

Pediatric palliative care across continents: Communication and shared-decision-making

Reply to Letter about whole genome sequencing in newborns

The Dilemmas of Artificial Wombs: Conventional Ethics and Science Fiction

The FDA’s Dueling Narratives: Protector Versus Obstacle

The Dilemmas of Artificial Wombs: Conventional Ethics and Science Fiction.

Understanding the Clinical Utility of Genome Sequencing in Critically Ill Newborns

A humane society after Dobbs?

Caution about COVID vaccines for kids

Nights of Plague and Lessons of History

UK Appeals Court Supports Ableism

The SARS-CoV-2 Lab-Leak Theory and the Dog That Did Not Bark

Converging Crises for Kids

COVID, Colonoscopies, and Certainty

What matters with Kansas

Three really good bioethics books

So? Gonna immunize your kids?

Conscience claims after Roe v. Wade

The reality of compulsory pregnancy

Making football safe for prayer

Helping Students Cheat

COVID Orphans: The Hidden Pandemic

Good science without pain

School shootings and political will

Thirteen Ways of Looking at Henrietta Lacks

The Moral Cost of Methodologic Rigor

Let's talk about gender identity

Current controversies in neonatal resuscitation

Current controversies in neonatal resuscitation.

Disposition Decisions in Cases of Medical Complexity and Health Inequity

The moral risk of methodological purity.

Ethical and epistemic issues in the design and conduct of pragmatic stepped-wedge cluster randomized clinical trials

Fetal Therapies and Clinical Research: Beyond Risk and Benefit

The moral risk of methodological purity

Suicide Risk in Adolescents During the COVID-19 Pandemic.

Ethics of care for the micropreemies. Just because we can, should we?

Disposition Decisions in Cases of Medical Complexity and Health Inequity.

Ethical and scientific complexity in debates about <scp>COVID</scp> vaccination in children

Should We Aspire to Be Rational About Letting Babies Die?

Next generation sequencing in neonatology: what does it mean for the next generation?

Ethics knowledge, attitudes, and experiences of tertiary care pediatricians in Ethiopia.

Ethics knowledge, attitudes, and experiences of tertiary care pediatricians in Ethiopia

17 First Attempt

Promoting COVID-19 Vaccination on Social Media

Index

7 What Are the Risks?

Balancing risks and benefits of open notes for neonatology.

IVF, Culture Wars, and "Joy"