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The role of ethics consultation in decision making for bariatric surgery in pediatrics
Richard E Boles1, Jaime M Moore1, Jacqueline J Glover2
1University of Colorado Anschutz Medical Campus, Department of Pediatrics, Aurora, CO 80045, United States.
Insights
Metabolic and bariatric surgery (MBS) for pediatric patients is increasingly accepted. Ethical considerations are crucial, especially for vulnerable groups, necessitating expert consultation to ensure patient well-being.
Area of Science:
- Pediatric Surgery
- Medical Ethics
Background:
- Metabolic and bariatric surgery (MBS) is gaining acceptance for pediatric patients.
- Established guidelines support MBS safety, efficacy, and cost-effectiveness.
- Ethical considerations are paramount in pediatric MBS cases.
Purpose of the Study:
- To highlight the importance of ethical consultation in pediatric MBS.
- To address ethical principles relevant to pediatric MBS.
- To guide institutions in developing structured ethical review processes.
Main Methods:
- Review of current evidence and guidelines for pediatric MBS.
- Analysis of ethical principles (autonomy, justice, beneficence, non-maleficence).
- Consideration of specific patient populations (preadolescents, intellectual disabilities).
Main Results:
- MBS is a viable option for pediatric patients with appropriate guidelines.
- Ethical challenges require careful navigation, particularly for specific patient groups.
- Collaboration with ethics consultants is beneficial for institutions.
Conclusions:
- Institutions should integrate ethics consultation into pediatric MBS pathways.
- A structured approach ensures ethical principles are addressed for all pediatric MBS candidates.
- Proactive ethical review supports safe and equitable patient care.
Abstract:
The decision to pursue metabolic and bariatric surgery (MBS) for pediatric patients has become increasingly accepted by patients and their families and by health care professionals. The advancement of pre- and post-operative MBS guidelines, based on accumulating evidence for safety, efficacy, and cost-effectiveness help to map the clinical pathway for MBS consideration. Ethical issues remain possible for each case, however, and consultation with ethical experts can provide clarity in the consideration of MBS. Specifically, ethical issues related to principles of autonomy, justice, beneficence, and non-maleficence may need to be resolved based on patient characteristics, including preadolescent patients and those who present with intellectual disabilities. Institutions that offer MBS for pediatric patients will benefit from collaborating with ethics consultants to develop a structured approach that helps ensure that ethical principles have been adequately addressed for patients presenting for MBS.
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