Introduction: Defining Cases in Pediatric Bioethics.

Abstract

The history and practice of pediatric bioethics, like medicine itself, is inherently case based. Just as anatomy, pathophysiology, and pharmacology are applied in making clinical decisions for pediatric patients, ethical theory, principles, standards, and frameworks must also be applied to each clinical encounter. Sometimes, this occurs without much thought or controversy, whereas other cases may be marked by the lack of a clear path or a conflict over the right and good decision. But in the clinical setting, unlike the classroom, decisions must be made. Since its inception, specific cases have captured the attention of ethics scholars and helped define pediatric bioethics, challenging existing practice, beliefs, or standards, requiring critical reflection and debate, and sometimes leading to the creation of new theories, understandings, and approaches. In the last 50 years, advances in medical technology, social changes altering the relationship between patients and their health care providers, the rise of the Internet, changes in attitudes about the moral worth of all children, and many other factors have changed the nature of medical decision-making for children and their families. The bioethics movement has expanded dramatically with these changes and has both influenced and been influenced by these changes in societal … Address correspondence to Aaron Wightman, MD, MA. E-mail: aaron.wightman@seattlechildrens.org