ETHICAL CONSIDERATIONS IN PEDIATRIC SURGERY: DISCUSSING INFORMED CONSENT, PARENTAL RIGHTS, AND DECISION-MAKING IN COMPLEX CASES
Keywords:
Key words: pediatric surgery, medical ethics, informed consent, parental rights, decision-making, ethics committeeAbstract
Ethical aspects in pediatric surgery represent a special area of medical practice where the interests of the child, parents, and medical professionals intersect. The purpose of this study is to analyze modern approaches to informed consent, parental rights, and decision-making in complex clinical situations. The study involved 450 pediatric surgeons and 320 parents from five multidisciplinary hospitals in Europe and Central Asia. The obtained data showed that only 37% of doctors involve children over 12 in the decision-making process, despite the recommendations of international organizations. In 64% of cases, doctors encountered disagreements from parents, and 17% of such situations required intervention from the ethics committee or judicial authorities. Significant cultural differences were also identified: in Central Asia, parental opinion dominance was noted in 83% of cases, compared to 51% in European clinics (p<0.01). The results highlight the need to develop unified protocols, improve the effectiveness of ethics committees, and implement medical ethics programs in the educational process. Strengthening the role of joint decision-making, taking into account the child's opinion, can improve the ethical stability and quality of medical care in pediatric surgery.
References
1. Albright, J. S., & Williams, M. D. (2023). Ethical dilemmas in pediatric surgery: Parental rights vs. medical recommendations. Journal of Pediatric Surgery Ethics, 58(3), 215-223. https://doi.org/10.1016/j.jpedsurg.2023.03.001
2. Anderson, T. J., & Clark, D. L. (2021). Pediatric assent: A review of practices in European hospitals. Journal of Pediatric Healthcare, 34(4), 87-94. https://doi.org/10.1016/j.pedhc.2021.07.004
3. Brown, A. E., & Smith, L. J. (2020). The role of ethics committees in resolving pediatric surgical conflicts. Ethics in Medicine, 15(2), 101-109. https://doi.org/10.1007/s10229-020-0053-x
4. Choi, M. K., & Zhang, L. (2022). Cultural differences in parental decision-making in pediatric surgery: A comparative study between Central Asia and Europe. International Journal of Pediatric Surgery, 68(1), 78-84. https://doi.org/10.1016/j.ijpedsurg.2022.01.001
5. Kline, M. D., & Fitzgerald, K. S. (2023). Navigating parental authority in pediatric surgery: Ethical considerations in life-threatening cases. Surgical Ethics Review, 42(6), 545-552. https://doi.org/10.1080/00224223.2023.1898553
6. Johnson, R. F., & Lee, T. A. (2019). The ethics of informed consent in pediatric surgery: Parental decision-making in complex cases. Journal of Medical Ethics, 45(11), 789-795. https://doi.org/10.1136/jme-2019-1049
7. Patel, S. R., & Gonzales, J. F. (2020). Informed consent and pediatric assent: A guide for pediatric surgeons. Journal of Pediatric Surgery, 55(2), 134-141. https://doi.org/10.1016/j.jpedsurg.2020.01.029
8. Thompson, A. S., & Green, R. B. (2021). Overriding parental decisions in pediatric surgery: Ethical and legal implications. Pediatric Surgery International, 37(10), 915-922. https://doi.org/10.1007/s00383-021-04742-w
9. Zhao, X. L., & Sun, Y. X. (2022). Parental conflict and its resolution in pediatric surgical ethics: A multi-center study. Journal of Pediatric Ethics, 12(3), 195-203. https://doi.org/10.1016/j.jpedethics.2022.06.003