"Because the discipline of medical ethics has developed with autonomy as its foundation, the field has ignored pediatric ethics. The book is resoundingly successful in its effort to rectify this problem. . . . [A] pleasure to read." —Eric D. Kodish, M.D., Director, Rainbow Center for Pediatric Ethics, Case Western Reserve University
Using a form of medical ethnography to investigate a variety of pediatric contexts, Richard B. Miller tests the fit of different ethical approaches in various medical settings to arrive at a new paradigm for how best to care for children. Miller contends that the principle of beneficence must take priority over autonomy in the treatment of children. Yet what is best for the child is a decision that doctors cannot make alone. In making and implementing such decisions, Miller argues, doctors must become part of a "therapeutic alliance" with families and the child undergoing medical care to come up with the best solution.
Children, Ethics, and Modern Medicine combines strong philosophical argumentation with firsthand knowledge of the issues facing children and families in pediatric care. This book will be an invaluable asset to medical ethicists and practitioners in pediatric care, as well as parents struggling with ethical issues in the care of their children.
Part I. Moral Contours
1. Parental Responsibility in Fear and Trembling
2. The Duty to Care
3. Pediatric Paternalism
4. Representing Patients
5. Basic Interests
Part II. Practical Cases
6. A Fighter, Doing God's Will: Technologically Tethered, Retaining
Fluids, on Steroids, Sedated, and Four Years Old
7. Respecting Jackson Bales's Religious Refusal: On What Grounds?
8. Ericka's Sepsis, Lia's Convulsions, and Cultural Differences
9. (Properly) Marginalized Altruism: Screening Kidney Donations from
10. The Politics and Ethics of a Hospital Ethics Committee
11. Ethical Issues in Pediatric Research
Conclusion: On Liberal Care