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


Book Description

This book examines the many ethical issues that are encountered in the Pediatric Intensive Care Unit (PICU). It supports pediatricians, nurses, residents, and other providers in their daily management of critically ill children with the dilemmas that arise. It begins by examining the evolution of pediatric critical care, and who is now impacted by this advancing medical technology. Subsequent chapters explore specific ethical concerns and controversies that are commonly encountered. These topics include how to conduct end-of-life discussions with families facing a myriad of challenging choices. It goes on to explore the concept of futility, and what that does and does not mean in the pediatric ICU setting. Controversial subjects such as children as organ donors, particularly using donation after cardiac death, in addition to issues surrounding the declaration of brain death are covered. Additional chapters address resource allocation, and also analyze the use of long-term technology in chronically critically ill children. Chapters include case examples with guidance on how to work through similar difficulties and decision-making. While this book is specifically targeted for care providers at the ICU bedside, it is also of benefit to medical students, students in bioethics, practicing ethical consultants and families who are dealing with critically ill children.




Bioethics


Book Description

The questions and dilemmas of bioethics touch everyone. Should people who refuse to be vaccinated be treated for COVID-19, even if that displaces vaccinated patients with other serious conditions? What restrictions on abortion should there be, if any? Should women be paid to donate eggs? Bioethics: What Everyone Needs to Know ® discusses these and other similar questions facing the public today--as well as providing a way for thinking deeply about them. Steinbock and Menzel first examine major moral theories and how they can be used to analyze bioethical issues. They then provide historical background to the birth of bioethics and explain how it shifted from a paternalistic doctor knows best approach to respect for autonomy, a fundamental value in contemporary bioethics. Subsequent chapters cover advance directives, experimentation on human subjects, the definition of death, physician-assisted dying, abortion, disability, just healthcare systems, the allocation of scarce resources, pharmaceutical drug pricing, assisted reproductive technology, egg donation, surrogate motherhood, sex selection, and the genetic modification of humans. Race and gender are considered throughout, as are the ethical issues raised by pandemics. Steinbock and Menzel consider the controversial questions that surface in the public sphere, explaining the facts, and then evaluating different approaches to resolving them.




Pediatric Palliative Care


Book Description

Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.




Pediatric Ethics: Theory and Practice


Book Description

This book assists health care providers to understand the specific interplay of the roles and relationships currently forming the debates in pediatric clinical ethics. It builds on the fact that, unlike adult medical ethics, pediatric ethics begins within an acutely and powerfully experienced dynamic of patient-family-state-physician relationship. The book provides a unique perspective as it interacts with established approaches as well as recent developments in pediatric ethics theory, and then explores these developments further through cases. The book first focuses on setting the stage by introducing a theoretical framework and elaborating how pediatric ethics differ from non-pediatric ethics. It approaches different theoretical frameworks in a critical manner drawing on their strengths and weaknesses. It helps the reader in developing an ability to engage in ethical reasoning and moral deliberation in order to focus on the wellbeing of the child as the main participant in the ethical deliberation, as well as to be able to identify the child’s moral claims. The second section of the book focuses on the practical application of these theoretical frameworks and discusses specific areas pertaining to decision-making. These are: the critically ill child, new and enduring ethical controversies, and social justice at large, the latter of which includes looking at the child’s place in society, access to healthcare, social determinants of health, and vaccinations. With the dynamic changes and challenges pediatric care faces across the globe, as well as the changing face of new technologies, no professional working in the field of pediatrics can afford not to take due note of this resource.




Recent Advances in Paediatrics - 29


Book Description

Recent Advances in Paediatrics-29 features an outstanding collection of articles relevant to paediatricians and health professionals working with children and adolescents across the world. The book reflects the changing landscape in paediatrics, with significant emphasis on adolescent health, both physical and mental, and references the role of technology and innovations such as conversational artificial intelligence (AI) and ChatGPT in improving outcomes. Other topics include prenatal screening and diagnosis of genetic defects, advances in neonatal care, a systematic approach towards orthopaedic management of cerebral palsy, bone health and osteoporosis, as well as advances in surgery and urology. The text features chapters on “safer care for sick children” with the role of safety checklists and escalation of care using hub and spoke models covered in depth to encourage universal high standards of care. This book is a compelling read for medical students explaining aspects of paediatrics often not covered in conventional textbooks, and furthermore provides an effective revision tool for DCH and MRCPCH examinations. It will also be of interest to practising clinicians wishing to keep up to date with the latest advances in their field. All chapters are written by expert authors ensuring authoritative and accurate content, and full colour photographs supplement enhance the comprehensive text.




Clinical Ethics in Pediatrics


Book Description

This volume provides a practical overview of the ethical issues arising in pediatric practice. The case-based approach grounds the bioethical concepts in real-life situations, covering a broad range of important and controversial topics, including informed consent, confidentiality, truthfulness and fidelity, ethical issues relating to perinatology and neonatology, end-of-life issues, new technologies, and problems of justice and public health in pediatrics. A dedicated section also addresses the topics of professionalism, including boundary issues, conflicts of interests and relationships with industry, ethical issues arising during training, and dealing with the impaired or unethical colleague. Each chapter contains a summary of the key issues covered and recommendations for approaching similar situations in other contexts. Clinical Ethics in Pediatrics: A Case-Based Textbook is an essential resource for all physicians who care for children, as well as medical educators, residents and scholars in clinical bioethics.




When Children Die


Book Description

The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.




Ethics, Conflict and Medical Treatment for Children E-Book


Book Description

What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents' wishes? The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world. In this book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict. From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new 'dissensus' framework for future cases of disagreement. - This new book critically examines the core ethical questions at the heart of disputes about medical treatment for children. - The contents review prominent cases of disagreement from the UK and internationally and analyse some of the distinctive and challenging features around treatment disputes in the 21st century. - The book proposes a radical new framework for future cases of disagreement around the care of gravely ill people.




Nursing Care of the Critically Ill Child


Book Description

Now completely up to date to meet the needs of today's pediatric nurses, Mary Fran Hazinski's Nursing Care of the Critically Ill Child, 3rd Edition, remains the foundational text of pediatric critical care nursing. Known for its outstanding organization and clear descriptions, this comprehensive reference details the unique care required for critically ill children with thorough discussions of physiology, pathophysiology, pharmacology, collaborative management, and nursing management. Ten new chapters, new advanced practice content, and new nurse contributors and reviewers ensure that this classic text continues to be the essential resource for the care of critically ill children. Details differences in caring for critically ill children as compared with caring for adults: how to modify assessment procedures, consider aspects of psychosocial development, and examine developmental aspects of various body systems. Provides comprehensive coverage of physiology, pathophysiology, pharmacology, and nursing management related to care of the critically ill child. Includes detailed Nursing Care Plans for select disorders. Contains helpful appendices such as pediatric drug dosages, central venous catheter care, and pediatric fluid requirements. Features Evolve online resources with additional content for further study of related topics, including tables for ease of recollection of material and additional references. Contains 10 all-new chapters, including Pharmacokinetics and Pharmacodynamics; Shock, Cardiac Arrest, and Resuscitation; Mechanical Support of Cardiopulmonary Function; Fluid, Electrolyte, and Endocrine Problems; Immunology and Infectious Disorders; Transplantation and Organ Donation; Toxicology/Poisonings; Fundamentals of Quality Improvement and Patient Safety; Clinical Informatics; and Ethical Issues in Pediatric Critical Care Features nurse contributors and reviewers for every chapter, making this edition a truly collaborative text. Provides information vital to the advanced practice nurse, such as assessment tools and severity of illness management. Includes numerous Pearls that highlight practical wisdom from experts in pediatric critical care nursing.




Pediatric Psycho-oncology


Book Description

Pediatric Psycho-Oncology is a comprehensive handbook that provides best practice models for the management of psychological, cognitive, and social outcomes of adolescents living with cancer and their families. Chapters cover a wide range of topics including psychological aspects of particular pediatric cancers and their treatments, how to talk to a child and family at critical times during the disease course, genetic testing, individual, family, educational, psychological and psychiatric interventions, and caring for international patients . Each chapter highlights the necessity of embracing an interdisciplinary approach to ensure that each child has the best options for living with cancer and, when cure is not possible, that death occurs with as much dignity as possible for the child and family. An extensive resource section is appended to provide information on written, online, video, community, national and international services and programs. This book features contributions from experts designed to help clinicians review, anticipate and respond to emotional issues that often arise in the context of treating pediatric cancer patients. Numerous cross-references and succinct tables and figures make this concise reference easy to use. Pediatric Psycho-Oncology is an ideal resource for helping pediatric oncologists and nurses recognize when it may be best to refer patients to their mental health colleagues and for those who are establishing pediatric oncology services or adding psychosocial components to existing clinics.