Ethical Considerations in Critically Ill Neonatal and Pediatric Patients

Area of Science:

• Medical Ethics
• Pediatric Critical Care
• Communication Strategies

Background:

• Care for critically ill neonates and pediatric patients presents significant emotional and ethical challenges.
• Improved patient, family, and care team experiences are linked to better ethical understanding and communication.
• Congenital diaphragmatic hernia (CDH) serves as a framework for exploring ethical and communication issues in this population.

Purpose of the Study:

• To explore ethical and communication considerations in critically ill neonates and pediatric patients.
• To provide a review of state-of-the-art topics in ethics, communication, and palliative care.
• To offer practical communication concepts for multidisciplinary teams.

Main Methods:

• A multidisciplinary panel session was conducted at the American Academy of Pediatrics National Conference in 2022.
• A theoretical congenital diaphragmatic hernia (CDH) case was used as an example.
• Live audience responses from the interactive session were included.

Main Results:

• The review covers key topics including terminology, trauma-informed communication, goals of care, futility, and parental discretion.
• It addresses ethical frameworks and the redirection of care.
• Practical communication concepts and educational principles are presented.

Conclusions:

• This primer equips multidisciplinary teams with principles and concepts for compassionate, family-centered, and evidence-based communication.
• It aims to optimize the care experience for critically ill children and their families.
• Applicable to various specialties involved in pediatric critical care and surgery.