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Ethics and the pediatric surgeon
Mary E Fallat1, Donna A Caniano, Annie H Fecteau
1Division of Pediatric Surgery, Department of Surgery, University of Louisville, Louisville, KY 40202, USA. mefall01@louisville.edu
Insights
Pediatric surgeons show interest in clinical ethics, particularly concerning patient care dilemmas. Education on surgical ethics is preferred via well-referenced manuscripts to address complex issues.
Area of Science:
- Pediatric Surgery
- Medical Ethics
- Bioethics
Background:
- Pediatric surgeons frequently encounter ethical concerns when treating children with severe congenital and acquired disorders.
- Managing these complex cases requires a strong understanding of clinical ethics.
Purpose of the Study:
- To assess the level of interest in clinical ethics among pediatric surgeons.
- To understand how pediatric surgeons manage ethical dilemmas in clinical scenarios.
Main Methods:
- A 12-item validated questionnaire was distributed to members of the American Pediatric Surgical Association (APSA).
- The survey covered topics including informed consent, patient privacy, and the definition of research in pediatric surgery.
Main Results:
- A 28.4% response rate was achieved from 235 APSA members.
- Controversial topics included minor consent, decision-making for neurologically devastated children, research definition, interpreter use, and patient privacy.
- A majority preferred well-referenced manuscripts for ethics education.
Conclusions:
- Pediatric surgeons demonstrate a general interest in clinical ethics relevant to patient care.
- The Ethics and Advocacy Committee should provide educational resources on surgical ethics topics.
Purpose:
Care of infants and children with life-impairing or life-threatening congenital and acquired disorders often raises ethical concerns for pediatric surgeons. The purpose of this survey was to determine the level of interest in clinical ethics and how respondents would manage ethical dilemmas within several clinical case scenarios.
Methods:
A 12-item validated questionnaire developed by the Ethics and Advocacy Committee was provided for the American Pediatric Surgical Association (APSA; www.eapsa.org) members on the organizational website. General categories of questions included informed consent, patient privacy, and what constitutes research.
Results:
The survey was completed by 235 of the 825 APSA members; a response rate of 28.4%. The majority (62%) were in academic practice, 22% had additional education or an advanced degree in ethics, and 11% were members of a hospital ethics committee. There was a clear majority response for seven questions. Topics generating the most controversy included the impact of consent by minors, decision making in the neurologically devastated child, what constitutes research in pediatric surgery, the use of interpreters for consent, and patient privacy. Respondents chose a well-referenced manuscript as the preferred modality for ethics education of the APSA members.
Conclusion:
Pediatric surgeons have a general interest in clinical ethics as it relates to the care of their patients. An important mission of the Ethics and Advocacy Committee can be to provide education that gives guidance and knowledge to the members of APSA on timely topics in surgical ethics.
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