Toward Standard Approaches for Notification and Direct Communication with Families in Pediatric Clinical Ethics...

The ASBH Core Competencies identify two core features of clinical ethics consultation: (1) identify and analyze the nature of the value uncertainty and (2) facilitate the building of a "principled ethical resolution." Central to these processes is understanding the perspective of the patient and/or their surrogate, yet the practices of notification and communication with surrogates, often parents, are varied in pediatric ethics consultation. In this paper we will review guidance on notification and communication with surrogates in clinical ethics consultation, the published literature on practices in US pediatric clinical ethics consultation in particular, and analyze justifications for and against routine notification and communication. Finally, we will present draft guidance for a standard approach to communication with families in pediatric ethics consultation.