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Viewing Pediatric Food Oral Immunotherapy Through an Ethical Lens-A Narrative Systematic Review
Jaclyn Bjelac1, Marcus Shaker2, Matthew Greenhawt3
1Food Allergy Center of Excellence, Center for Pediatric Allergy and Immunology, Cleveland Clinic, Cleveland, Ohio.
The Journal of Allergy and Clinical Immunology. in Practice
|March 25, 2023
Summary
Food oral immunotherapy (OIT) offers benefits for children with food allergies, but ethical considerations are crucial. Applying principles like autonomy and beneficence ensures safe and equitable OIT implementation for families.
Area of Science:
- Pediatric Allergy and Immunology
- Bioethics
- Clinical Decision-Making
Background:
- Food allergy is a prevalent, lifelong condition in children.
- Food oral immunotherapy (OIT) is an emerging management strategy.
- Ethical principles guide OIT discussions, especially for pediatric patients.
Purpose of the Study:
- To examine the implementation of OIT in children using an ethical framework.
- To analyze the ethical considerations surrounding OIT for pediatric food allergies.
Main Methods:
- Literature search for published ethical frameworks related to OIT.
- Evaluation of ethical principles in parental decision-making for OIT.
- Analysis of shared decision-making in pediatric OIT.
Main Results:
- Harm, basic interest, and best interest principles inform parental OIT decisions.
- Shared decision-making is key to personalized OIT care and minimizing discord.
- OIT can improve well-being, but equity and access challenges persist.
Conclusions:
- Ethical principles, including autonomy, beneficence, nonmaleficence, and justice, are fundamental to OIT.
- Tailoring OIT to individual patient-family needs is essential.
- Addressing equity and support is vital for broader OIT access.
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