What moral precepts ought to guide parents and clinicians in medical decision making for children?
That fundamental question is the basis for a recent article published in the journal Pediatrics. Mark Navin, professor and chair in Oakland University’s Department of Philosophy, co-authored the article with 16 other leading pediatric bioethicists from diverse philosophical traditions and disciplinary perspectives.
The article resulted from a 2022 symposium the co-authors attended called “Best Interests and Beyond: Standards of Decision Making in Pediatrics.” They spent the three-day event building consensus on a topic known for being highly contentious – particularly amongst themselves.
“What's most notable about the article is that it is written by people who have been disagreeing with each other in the journals for 20-30 years,” said Navin. “Given that pediatricians and their patients need clear ethical guidance, the creation of a consensus document is a major accomplishment. It also shows the power of honest and open dialogue to help people find agreement where there may have first appeared to be little opportunity to do so.”
With the primary goals of accessibility, teachability, and feasibility for practicing clinicians, parents and legal guardians, the co-authors generated six consensus recommendations for making clinical decisions on behalf of child patients:
Next steps will be to test the recommendations to determine how they apply to specific circumstances and pediatric populations, such as newborns, teenagers and wards of the state, and whether changes may be necessary.