Ethical Considerations in Critically Ill Neonatal and Pediatric Patients

Title

Ethical Considerations in Critically Ill Neonatal and Pediatric Patients

Creator

Harting MT; Munson D; Linebarger J; Hirshberg E; Gow KW; Malek MM; Robbins AJ; Turnbull J

Publisher

Journal of Pediatric Surgery

Date

2023

Subject

Ethics; Palliative care; Infant Newborn; Communication; Critical Illness; Critical care; Congenital diaphragmatic hernia

Description

Summary The care of critically ill neonates and pediatric patients can be particularly emotionally and ethically challenging. Emerging evidence suggests that we can improve the patient, family, and care team experience in the critical care setting through a better understanding and application of ethical frameworks and communication strategies. We conducted a multidisciplinary panel session at the American Academy of Pediatrics National Conference and Exhibition in the fall of 2022 wherein we explored a myriad of ethical and communication considerations in this unique patient population, with congenital diaphragmatic hernia (CDH) as the congenital anomaly/disease framework. In this review, we will cover state of the art topics in ethics, communication, and palliative care including basic terminology, communication strategies such as trauma-informed communication, establishing/evolving goals of care, futility, medically inappropriate treatment, ethical frameworks, parental discretion, establishing milestones, internal/external intentions, and re-direction of care. These topics will be helpful to many specialties who are involved in the care of critically ill neonates and children including maternal fetal medicine, pediatrics, neonatology, pediatric critical care, palliative care, and pediatric surgery, along with the pediatric surgical subspecialties. We use a theoretical CDH case as an example and include the live audience responses from the interactive session. This primer provides overarching educational principles, as well as practical communication concepts, that can cultivate compassionate multidisciplinary teams, equipped to optimize family-centered, evidence-based compassionate communication and 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

April List 2023

Collection

Citation

Harting MT; Munson D; Linebarger J; Hirshberg E; Gow KW; Malek MM; Robbins AJ; Turnbull J, “Ethical Considerations in Critically Ill Neonatal and Pediatric Patients,” Pediatric Palliative Care Library, accessed June 19, 2024, https://pedpalascnetlibrary.omeka.net/items/show/19025.