INTRODUCTION TO
PEDIATRICS BIOETHICS
Guillermo Godoy, MD
Professor of Pediatrics and Obstetrics
University of Alabama, Tuscaloosa
DCH Health System, NICU’s
THE UNIVERSITY OF
ALABAMA
AMERICAN FOOTBALL
UA STADIUM
“ETHICS” DEFINITION
• Set of moral principles
“ETHICS” DEFINITION
• Set of moral principles
• Set of rules governing a particular class of
human actions
“ETHICS” DEFINITION
• Set of moral principles
• Set of rules governing a particular class of
human actions
• Branch of Philosophy dealing with values
relating to human conduct. Their rightness
and wrongness of actions, motives and ends
Ethics principles
• RESPECT OF THE INDIVIDUAL
• BENEVOLENCE
• NONMALEFICENCE
• JUSTICE
Ethics quandary
THE DECISION MAKING PROCESS
ETHICS
and
THE
decision
MAKING
process in adults
Patient
Health
Care Team
THE PEDIATRIC decision
making ETHICAL CONFLICT
Parents
C H I LD
Society
Health
Care
ETHICS IN PEDIATRICS
ethical fields
• CLINICAL
ETHICS IN PEDIATRICS
ethical fields
• CLINICAL
• RESEARCH
ETHICS IN PEDIATRICS
ethical fields
• CLINICAL
• RESEARCH
• ALLOCATION
ETHICS IN PEDIATRICS
ethical fields
• CLINICAL
• RESEARCH
• ALLOCATION
• PUBLIC POLICY
CLINICAL ETHICS
• Who the decisions affects
CLINICAL ETHICS
• Who the decisions affects
• Who influence these decisions
CLINICAL ETHICS
• Who the decisions affects
• Who influence these decisions
• The Best Interest Standard
CLINICAL ETHICS
• Who the decisions affects
• Who influence these decisions
• The Best Interest Standard
• The QUAD model of Ethical questions
THE “QUAD” FRAMEWORK OF
ETHICS QUESTIONs SOLVING
DEFINITION
UNDERSTANDING
ASSESSMENT
RECOMMENDATIONS
THE PRINCIPAL OF HUMAN
RESEARCH:
THE INFORMED CONSENT
• Utilitarian
THE PRINCIPAL OF HUMAN
RESEARCH:
THE INFORMED CONSENT
• Utilitarian
• Deontological
• Contractualisms
THE PRINCIPAL OF HUMAN
RESEARCH:
THE INFORMED CONSENT
• Utilitarian
• Deontological
• The risk-benefit equation
THE IRB
foundation
• Who needs the protection
• Therapeutic v. non-therapeutic
• The Duty to Act:
LOW DISTANT RISK
HIGH DISTANT RISK
Allocation of
resources
Parents
Society/Law
Health Care
Approved
v. not
Approved
ETHICS IN PUBLIC
POLICY
Organ Transplantation for Children:
* How are organs allocated?
Scores for survival v. sickness
* Organ transplants and Medical
Ethics:
Donor v. Recipient
ETHICS IN PUBLIC
POLICY
* Orphan Disorders and Orphan Drugs:
Resources usage in rare
disorders:
The Many v. The Few
*
The Social Media Factor