Clinical Ethics in Pediatrics: An International Perspective

Area of Science:

• Pediatric clinical ethics
• Bioethics
• Medical ethics

Background:

• The development of clinical ethics in pediatrics in the United States over the past 40 years.
• Prevalence of ethics committees in children's hospitals.
• Low consultation rates for these committees.

Purpose of the Study:

• To review the evolution of pediatric clinical ethics in the US.
• To explore reasons for low ethics committee consultation rates.
• To compare the development of pediatric ethics internationally.

Main Methods:

• Literature review on the development of clinical ethics in US pediatric hospitals.
• Analysis of consultation patterns for hospital ethics committees.
• Comparative review of international approaches to pediatric clinical ethics.

Main Results:

• Most children's hospitals in the US have ethics committees, but they are infrequently consulted.
• Speculation that ethical dilemmas are discussed in informal settings.
• Pediatric clinical ethics has developed distinct trajectories in different countries.

Conclusions:

• The role of ethics consultants may extend beyond formal consultations to shaping institutional ethical climates.
• Further research is needed to understand the optimal functioning of ethics committees in pediatrics.
• International comparisons highlight diverse models for advancing pediatric clinical ethics.