INTRODUCTION TO INTRODUCTION TO PEDIATRICS PEDIATRICS BIOETHICSBIOETHICS

Guillermo Godoy, MDGuillermo Godoy, MD

Professor of Pediatrics and ObstetricsProfessor of Pediatrics and Obstetrics

University of Alabama, TuscaloosaUniversity of Alabama, Tuscaloosa

DCH Health System, NICU’sDCH Health System, NICU’s

THE UNIVERSITY OF THE UNIVERSITY OF ALABAMAALABAMA

AMERICAN FOOTBALLAMERICAN FOOTBALLUA STADIUMUA STADIUM

““ETHICS” ETHICS” DEFINITIONDEFINITION

• Set of moral principlesSet of moral principles

““ETHICS” ETHICS” DEFINITIONDEFINITION

• Set of moral principlesSet of moral principles

• Set of rules governing a particular Set of rules governing a particular class of human actionsclass of human actions

““ETHICS” ETHICS” DEFINITIONDEFINITION

• Set of moral principlesSet of moral principles

• Set of rules governing a particular Set of rules governing a particular class of human actionsclass of human actions

• Branch of Philosophy dealing with Branch of Philosophy dealing with values relating to human conduct. values relating to human conduct. Their rightness and wrongness of Their rightness and wrongness of actions, motives and endsactions, motives and ends

Ethics principlesEthics principles

•RESPECT OF THE RESPECT OF THE INDIVIDUALINDIVIDUAL

•BENEVOLENCEBENEVOLENCE

•NONMALEFICENCENONMALEFICENCE

• JUSTICEJUSTICE

Ethics quandaryEthics quandary

THE DECISION MAKING THE DECISION MAKING PROCESSPROCESS

ETHICS and THE ETHICS and THE decision MAKING decision MAKING process in adultsprocess in adults

THE PEDIATRIC decision THE PEDIATRIC decision making ETHICAL CONFLICTmaking ETHICAL CONFLICT

C H I LD

ETHICS IN ETHICS IN PEDIATRICSPEDIATRICSethical fieldsethical fields

•CLINICALCLINICAL

ETHICS IN ETHICS IN PEDIATRICSPEDIATRICSethical fieldsethical fields

•CLINICALCLINICAL

•RESEARCHRESEARCH

ETHICS IN ETHICS IN PEDIATRICSPEDIATRICSethical fieldsethical fields

•CLINICALCLINICAL

•RESEARCHRESEARCH

•ALLOCATIONALLOCATION

ETHICS IN ETHICS IN PEDIATRICSPEDIATRICSethical fieldsethical fields

•CLINICALCLINICAL

•RESEARCHRESEARCH

•ALLOCATIONALLOCATION

•PUBLIC POLICYPUBLIC POLICY

CLINICAL ETHICSCLINICAL ETHICS

•Who the decisions affectsWho the decisions affects

CLINICAL ETHICSCLINICAL ETHICS

•Who the decisions affectsWho the decisions affects

•Who influence these Who influence these decisionsdecisions

CLINICAL ETHICSCLINICAL ETHICS

•Who the decisions affectsWho the decisions affects

•Who influence these Who influence these decisionsdecisions

•The Best Interest StandardThe Best Interest Standard

CLINICAL ETHICSCLINICAL ETHICS

• Who the decisions affectsWho the decisions affects

• Who influence these decisionsWho influence these decisions

• The Best Interest StandardThe Best Interest Standard

• The QUAD model of Ethical questionsThe QUAD model of Ethical questions

THE “QUAD” FRAMEWORK OFTHE “QUAD” FRAMEWORK OFETHICS QUESTIONs SOLVINGETHICS QUESTIONs SOLVING

DEFINITION UNDERSTANDING

ASSESSMENT RECOMMENDATIONS

THE PRINCIPAL OF HUMAN THE PRINCIPAL OF HUMAN RESEARCH:RESEARCH:

THE INFORMED CONSENTTHE INFORMED CONSENT

•UtilitarianUtilitarian

THE PRINCIPAL OF HUMAN THE PRINCIPAL OF HUMAN RESEARCH:RESEARCH:

THE INFORMED CONSENTTHE INFORMED CONSENT

•UtilitarianUtilitarian

•DeontologicalDeontological

•ContractualismsContractualisms

THE PRINCIPAL OF HUMAN THE PRINCIPAL OF HUMAN RESEARCH:RESEARCH:

THE INFORMED CONSENTTHE INFORMED CONSENT

•UtilitarianUtilitarian

•DeontologicalDeontological

•The risk-benefit equationThe risk-benefit equation

THE IRB foundationTHE IRB foundation• Who needs the protectionWho needs the protection

• Therapeutic v. non-therapeuticTherapeutic v. non-therapeutic

• The Duty to Act:The Duty to Act:

Allocation of Allocation of resourcesresources

ETHICS IN PUBLIC ETHICS IN PUBLIC POLICYPOLICY

Organ Transplantation for Organ Transplantation for Children:Children:

* How are organs allocated? * How are organs allocated?

Scores for survival v. sicknessScores for survival v. sickness

* Organ transplants and Medical * Organ transplants and Medical

Ethics:Ethics:

Donor v. RecipientDonor v. Recipient

ETHICS IN PUBLIC ETHICS IN PUBLIC POLICYPOLICY

* Orphan Disorders and Orphan * Orphan Disorders and Orphan DrugsDrugs::

Resources usage in rare Resources usage in rare

disorders:disorders:

The Many v. The FewThe Many v. The Few

** The Social Media FactorThe Social Media Factor