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Ethics in neurodevelopmental disability
Eric Racine1, Emily Bell, Michael Shevell
1Neuroethics Research Unit, Institut de recherches cliniques de Montréal, Montreal, Canada; Department of Medicine and Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada; Departments of Neurology and Neurosurgery, McGill University, Montreal, Canada.
Insights
This review explores ethical considerations in caring for children with neurodevelopmental disabilities, such as autism spectrum disorder and cerebral palsy. It addresses decision-making, quality of life, and unproven therapies, highlighting challenges for families and clinicians.
Area of Science:
- Pediatrics
- Medical Ethics
- Neuroscience
Background:
- Neurodevelopmental disabilities (NDDs) significantly impact children, families, and healthcare systems.
- Common NDDs include autism spectrum disorder and cerebral palsy.
- Ethical considerations are paramount in the care of children with NDDs.
Purpose of the Study:
- To review common features of NDDs to understand associated ethical questions.
- To focus on key ethical areas in the care of developmentally challenged children.
- To inform clinicians and decision-makers regarding ethical principles.
Main Methods:
- Literature review of neurodevelopmental disorders.
- Analysis of ethical principles in clinical practice.
- Examination of decision-making, quality of life, and therapeutic interventions.
Main Results:
- Ethical questions arise in decision-making and autonomy for individuals with developmental disabilities.
- Quality of life is a persistent ethical issue intersecting with developmental disability.
- The use of unproven therapies and diagnostics presents significant ethical controversies.
Conclusions:
- Understanding NDDs is crucial for navigating complex ethical dilemmas.
- Ethical frameworks are needed to guide care, decision-making, and treatment choices.
- Further research and ethical guidelines are necessary to address the limited treatment options for NDDs.
Abstract:
Neurodevelopmental disabilities, like autism spectrum disorders and cerebral palsy are a common health problem in children. Given the impact of these conditions on children, families, and healthcare and social systems, the care of developmentally challenged children raises questions related to values and ethical principles. We review the common features of neurodevelopmental disorders that help understand the associated ethical questions. We focus on three major areas where ethical questions arise for clinicians and those involved in making decisions for or caring for these children: (1) the principles of decision-making and autonomy as they relate to developmental disability; (2) the issues related to quality of life that have long intersected with developmental disability; and (3) the use of unproven therapies and diagnostics that are particularly controversial given the extent that neurodevelopmental disabilities impact children and their families, yet active treatments options are limited.
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