The birth of tragedy in pediatrics: a phronetic conception of bioethics

Area of Science:

• Medical Ethics
• Pediatric Critical Care
• Moral Philosophy

Background:

• Current ethical standards (parental autonomy, child best interests) are insufficient for complex pediatric critical care dilemmas.
• A growing discourse recognizes 'tragedy' as a framework for specific, irresolvable moral problems.

Purpose of the Study:

• To propose a new moral framework for addressing tragic dilemmas in pediatric critical care.
• To introduce the concept of phronesis as the appropriate ethical conduct in such situations.

Main Methods:

• Analysis of moral discourse surrounding tragic dilemmas.
• Conceptualization of phronesis as practical wisdom in ethical decision-making.
• Emphasis on narrative creation as a tool for moral discernment.

Main Results:

• Tragic dilemmas involve irresolvable choices with unavoidable negative outcomes, leaving moral agents with 'dirty hands'.
• Phronesis enables discernment of good agency within tragic circumstances.
• Moral narratives are key to conveying and creating meaning in these situations.

Conclusions:

• The framework of tragedy and phronesis offers a more adequate approach to complex pediatric critical care ethics.
• Phronetic agents utilize storytelling to navigate and make sense of morally challenging situations involving critically ill children.