There have been several recent examples of the variety of things that can happen then. When a child is born with ambiguous internal or external genitalia, the affected persons, their families, and the attending medical team are put in a difficult situation.
This principle affirms the need for medical competence.
In modern pluralistic societies, there is no such criterion as an objective best interest standard for child care. We will delineate how the rights of the child and the future adult can best be defended by exploring the meaning of patient autonomy.
The rationale for this is that a small child is too young to decide himself if he agrees with his parents. As early as the age of 6 or 7, children are able to understand biological processes or to reflect on their identity [ 30 ].
Summary and critique The four principles currently operant in health care ethics had a long history in the common morality of our society even before becoming widely popular as moral action guides in medical ethics over the past forty-plus years through the work of ethicists such as Beauchamp and Childress.
The age is younger for so-called emancipated minors — those children who are entirely self-supporting or who are married.
The consequences of refusing a blood transfusion must be made clear to the patient at risk of dying from blood loss. A Theory of Justice. In particular, the role of the parents as legal representatives of the child is controversial.
We will also show why a moratorium on nonemergency intersex surgery in early childhood is not justified from an ethical point of view, and why family privacy has to be taken into account.
The distinction between means and effects. The Principle of Nonmaleficence The principle of nonmaleficence requires of us that we not intentionally create a harm or injury to the patient, either through acts of commission or omission. Intersex, Disorders of sex development, Ethics, Informed consent, Guidelines Differences of sex development DSD 1 —or intersex as it is sometimes called—has recently attracted considerable attention by pediatricians, endocrinologists, psychologists, and geneticists, as well as feminists, ethicists, and self-help groups [ 1 — 6 ].
Case 1 In a prima facie sense, we ought always to respect the autonomy of the patient. One of the most controversial issues in modern health care is the question pertaining to "who has the right to health care?
Dreger AD When medicine goes too far in the pursuit of normality. The nature of the act. His case dramatized a very grey area in medical ethics — when ought a young person be able to make these decisions on his own?
Arch Pediatr Adolesc Med. Family privacy and the best interest of the child A sound ethical justification for treatment decisions in early childhood is indeed the key to decision making in DSD.
They do not wish to assign a fundamentally pathological meaning to DSD. Sex reassignment at birth. Further, bioethicst Albert Jonsen and colleagues claim in their work that in order to rigorously apply these principles in clinical situations their applicability must start with the context of a given case.
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The demands of the principle of justice must apply at the bedside of individual patients but also systemically in the laws and policies of society that govern the access of a population to health care.
Knowing the extent to which taboos were previously associated with this subject and that affected persons still suffer stigmatization, the authors of these principles and recommendations aim to promote professionalism, respect, and tolerance in the management of DSD and to counteract any stigmatizing behavior by the medical community and society.
The good effect must outweigh the evil that is permitted, in other words, the bad effect. Normality in medicine is a biological as well as a social criterion, and its meaning is changing over time. The child, therefore, should be granted partnership status and be involved in all examination and treatment steps, as appropriate to his or her developmental level.
This almost universal ethos demands both a caring and encouraging human relationship between parent and child and respect for each and every child [ 29 ].
The right to represent the child and to decide on its behalf is normally accorded to the parents as legal guardians.
There are exceptions, as with all things in medicine. Respect for Autonomy Any notion of moral decision-making assumes that rational agents are involved in making informed and voluntary decisions. I have been involved in a few of those cases.
Likewise, when interventions that might have such consequences are refrained from, explicit reasoning and justification are required to back this up. The ethics work group identified four scientific and social tendencies as the major driving forces that led to a thorough reappraisal of former treatment regimes in DSD: However, we do not deny that there may be conditions requiring medical intervention.
The team should always consist of competent representatives from the fields of medicine, nursing, psychology, and psychotherapy as well as social workers. The authors are fully aware of the problems associated with these issues, respect the disconcertment and the rejection caused by foreign assignation of gender roles, and accept that alternative concepts exist among individuals.
For example, homosexuality was treated as a biological and psychological abnormality of sexual development, but is no longer today. Hence, the following communication on DSD will address aspects of both concepts.
What should we do when such a near-adult and her parents disagree about the treatment the child should get?The place of principles in bioethics. Ethical choices, both minor and major, confront us everyday in the provision of health care for persons with diverse values living in a pluralistic and multicultural society.
Further, before implementing the medical care plan, it is now commonly accepted that the patient must be given an opportunity to. Nov 06, · Keywords: emergency medical care, pediatric care, pediatric diseases, childhood accidents, emergency medical service Polls among emergency physicians have revealed that delivering pre-hospital emergency care to children causes extreme emotional stress and anxiety (1).
Organizational Principles to Guide and Deﬁne the Child Health Care System and/or Improve the Health of all Children PEDIATRICS VolumeNumber 4, medical care of children as demonstrated by training, clinical experience, or fo-cused continuing medical education.
c. Maintains competency in pe. This policy statement from the American Academy of Pediatrics reviews the epidemiology of medical errors in children, examines unique issues in safety for pediatric patients, and discusses specific approaches to improving safety in pediatrics.
Principles of pediatric patient safety:. Therefore, the American Academy of Pediatrics urges the use of the key principles outlined in this statement in designing and implementing managed care programs for newborns, infants, children, adolescents, and young adults to maximize the positive potential of managed care for pediatrics.
Nursing Care of Children: Principles and Practice (James, Nursing Care of Children): Nursing Care of Children: Principles and Practice (James, Nursing Care of Children) 4th Edition. #36 in Books > Medical Books > Nursing > Pediatrics/5(27).Download