Bioethics forum
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As science progresses, new issues in bioethics grab the headlines, but in neonatal medicine communication and decision making for sick and premature infants is as important today as it was thirty years ago. Decisions have to be made and made well, despite suboptimal time, data, or knowledge. To this end, the authors propose good communication and a cooperative model as key to interpreting the best interest standard in a way that respects parental rights and responsibility and allows best interest to be decided from an amalgam of medical facts and human values.
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The death of a child is perhaps the worst tragedy a family ever has to endure. The communication that occurs among children, parents, and healthcare professionals at the end of a child's life must be grounded in caring, and compassionate relationships. These relationships require particular skills, knowledge and attitudes that are not fully addressed in many approaches to communication training currently available to practitioners. This essay proposes elements of a pedagogy for relational and communicative competence in pediatric palliative care that is rooted in ethical and ethnographic principles.
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How can healthcare professionals, most of whom have never personally been confronted with such tragic situations, best help parents and their children make decisions about life and death that will minimize the suffering of children and their parents? Research studies and the professional experience of those attuned to these problems can be instructive. This paper reviews and gives advice about the communication between healthcare professionals and parents and children facing life and death.
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Adverse encounters with patients can frustrate any physician. The dilemma arises, however, when physicians allow these frustrations to negatively affect their practice of medicine. Treating all patients respectfully should be the standard, but maintaining this standard is difficult for some physicians.