Ethical Problems in Pediatrics: A Dozen Dilemmas
by
Book Cover & Preview Text
Ethical Considerations
This case is not simply a decision on abortion or carrying the baby to term, as it might appear at first blush. There are other ethical considerations.
The wishes of the patient herself
The family dynamics (suppose, as does happen, she had been sexually abused by her step-father)
Role of the baby’s father (suppose, as does happen, the father wants her either to have the child and will support it, or conversely wants her to have an abortion).
This is a complex situation involving a teen-ager who is pregnant and needs some medical care and guidance almost immediately. This is not a situation that can exist through a year of psychotherapy to get at the roots of any problem that might exist. Steps must be taken soon--certainly medical/obstetrical processing. There is a family that must be considered and made aware before she starts to “show” or to have pregnancy symptoms. The “one-time thing” must be examined. Is it connected with bad family dynamics? Was it a hidden side of her personality? What is the role of the baby’s father, now or later? What is the maturity level of the patient? How sophisticated is she? How responsible is she? Is there a “serious love affair” with the baby’s father?
All this calls, not for the simple immediate decision of abortion or no abortion, but a careful examination of all the factors involved.
In any event, the ethical consideration is to do that which is in the best interests and desires of the patient, if at all possible—and maybe that’s what we as health professionals should do. We should seek ways to achieve her desires without damaging others along the way or doing anything illegal.
Then, there is the ethical consideration of the health professional himself or herself. Are you knowledgeable enough to handle this—both medically and psychologically? Are you comfortable with handling such a situation? Do you really want to be involved? Ethically, if the answer is “No” to those—any of them—you must see that the patient gets into good and understanding hands before you let go. You might want to stay in the picture as an anchor, as a confidante, as a liaison to the family, or whatever role you might play to help the patient and the family. That is satisfactory also—as long as you do not interfere with the actual medical care of the patient once she is in capable hands.
This is a situation that, in almost all cases, will have an unsatisfactory course or ending for someone (patient, family, baby’s father, society, the health professional) and that is to be expected because of the natural complexity, diametrical choices and strong feelings among so many people. As long as we accept that the ethics calls f
Formats
Book Details
About the Book
In this book, twelve captivating and down-to-earth ethical dilemmas are presented in an interactive learning mode.
“Ethics” generally conjures up visions of unusual life-and-death problems. However, health professionals – at every level and in every field -- sooner or later face more mundane situations involving ethical and moral decisions. Twelve of these interesting, challenging, day-to-day situations are thoroughly presented in this work.
Each of these (some actual, some created to illustrate) is isolated on an individual page, allowing the reader an unhampered chance to apply his or her own thoughts, ideas and options. On the page following, the author presents a set of possible action-options from which health professional can choose; again, the reader, without the distraction of “answers” on the same page, can think through the problems alone – and even select the “best” one. This is followed by the author’s discussion/opinion of each option and concludes with some general ethical considerations.
Supplementing this is an unusual presentation: each situation is followed by a Second Opinion, offered by a health professional expert other than the author -- some in agreement, some not.
Together, this approach exposes the reader to multiple choices and an opportunity to consider actively a number of ethical problems. This creates a self-instructive, inter-active learning process, something not generally found in print.
On the other hand, this work can be read strictly as a pleasurable book, transmitting ethical information and allowing the reader to enjoy and think about these situations.
About the Author
Through three careers – Pediatrics, Medical Education and Medical Communication – Dr. Melnick has had the opportunity to observe and experience a great variety of ethical situations and problems involving children and adolescents. The essence of those years has been distilled in this book.
Following his 30 years of private pediatric practice, he became Founding Dean of the Southeastern College of Osteopathic Medicine. In the growth and development of that institution, he also helped establish five additional health professions colleges – Pharmacy, Optometry, Allied Health, Medical Sciences and Dentistry. This led to his position as Executive Vice Chancellor and Provost of the Health Professions Division of Nova Southeastern University. Since his retirement a few years ago, he has devoted himself to Medical Communication.
He has served as Chairman of Pediatrics at two hospitals, and as Associate Pediatrician at two others, including Children’s Hospital of Philadelphia In addition, he was President of the America College of Osteopathic Pediatricians and Chairman of the certifying body — the American Osteopathic Board of Pediatrics
Along the way, he served as president or chair of ten professional organizations, taught in four medical schools, and has been honored with fifteen distinguished service awards. Dr. Melnick holds five Fellowships from professional organizations. He remains Professor of Pediatrics and Public Health at the NSU College of Osteopathic Medicine and he writes extensively, having more than 140 published articles and six books..
All these activities have enhanced his views of and interest in Pediatric Ethics.