Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda

Title

Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda

Creator

Clark JD; Baden HP; Berkman ER; Bourget E; Brogan TV; Di Gennaro JL; Doorenbos AZ; McMullan DM; Roberts JS; Turnbull JM; Wilfond BS; Lewis-Newby M

Publisher

Frontiers in Pediatrics

Date

2022

Subject

Communication; Ethics; Extracorporeal Membrane Oxygenation; Critical care; ECLS

Description

Technological advancements and rapid expansion in the clinical use of extracorporeal life support (ECLS) across all age ranges in the last decade, including during the COVID-19 pandemic, has led to important ethical considerations. As a costly and resource intensive therapy, ECLS is used emergently under high stakes circumstances where there is often prognostic uncertainty and risk for serious complications. To develop a research agenda to further characterize and address these ethical dilemmas, a working group of specialists in ECLS, critical care, cardiothoracic surgery, palliative care, and bioethics convened at a single pediatric academic institution over the course of 18 months. Using an iterative consensus process, research questions were selected based on: (1) frequency, (2) uniqueness to ECLS, (3) urgency, (4) feasibility to study, and (5) potential to improve patient care. Questions were categorized into broad domains of societal decision-making, bedside decision-making, patient and family communication, medical team dynamics, and research design and implementation. A deeper exploration of these ethical dilemmas through formalized research and deliberation may improve equitable access and quality of ECLS-related medical care.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

September 2022 List

Collection

Citation

Clark JD; Baden HP; Berkman ER; Bourget E; Brogan TV; Di Gennaro JL; Doorenbos AZ; McMullan DM; Roberts JS; Turnbull JM; Wilfond BS; Lewis-Newby M, “Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda,” Pediatric Palliative Care Library, accessed February 5, 2023, https://pedpalascnetlibrary.omeka.net/items/show/18272.

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