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Exhaust All Measures: Ethical Issues in Pediatric End-of-Life Care
Kara J Thieleman1, Cara Wallace2, Andrea N Cimino3
1a Arizona State University School of Social Work , Phoenix , Arizona , USA.
Insights
Pediatric end-of-life care presents unique ethical challenges for social workers. This study explores these conflicts using vignettes and National Association of Social Workers standards to guide resolution.
Area of Science:
- Medical Ethics
- Social Work
- Pediatric Palliative Care
Background:
- Child death profoundly impacts families and healthcare providers.
- Parents of critically ill children face unique challenges in decision-making.
- Ethical conflicts in pediatric end-of-life care are understudied from a social work perspective.
Purpose of the Study:
- To explore ethical issues faced by social workers in pediatric end-of-life care.
- To apply National Association of Social Workers (NASW) standards to these ethical dilemmas.
- To provide a framework for social workers navigating complex end-of-life situations.
Main Methods:
- Utilized two case vignettes to illustrate ethical issues.
- Applied the NASW Standards for Palliative and End of Life Care (2004).
- Explored potential resolutions for identified ethical conflicts.
Main Results:
- Vignettes highlight the complex interplay of social work values, bioethics, and psychosocial factors.
- Identified specific ethical challenges encountered by social workers.
- Demonstrated the utility of NASW standards in addressing these challenges.
Conclusions:
- Further research is needed to understand social workers' experiences in pediatric end-of-life care.
- The NASW standards offer a valuable resource for ethical decision-making.
- Social workers play a critical role in supporting families and patients during end-of-life care.
Abstract:
The death of a child may have a profound impact on parents, family members, and health care providers who provided care for the child. Unique challenges are faced by parents of seriously ill children as they must serve as the legal authority for health care decisions of children under age 18, although the child's wishes must also be considered. Social workers must balance core social work values, bioethical values, and psychosocial issues presented by such situations. While studies have been conducted with physicians and nurses regarding ethical issues in pediatric end-of-life care settings, little is known about how social workers experience these conflicts. This article utilizes two vignettes to illustrate potential ethical issues in this setting and applies the National Association of Social Workers Standards for Palliative and End of Life Care (NASW, 2004 ) to explore options for their resolution. These vignettes provide descriptions of possible reactions in this setting and can be used as a basis for further exploration of ethics in pediatric end-of-life care from a social work perspective.
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