Bioethics in the Pediatric ICU: Ethical Dilemmas Encountered in the Care of Critically Ill Children

Laura Miller-Smith, MDLaura Miller-Smith, MD, is a pediatric intensivist at Children’s Mercy Hospital in Kansas City, Missouri, and is a an Associate Professor of Pediatrics at University of Missouri in Kansas City.  She completed the Pediatric Bioethics Certificate Program at Children’s Mercy Center for Bioethics, and currently serves as Chairperson of the Hospital Ethics Committee.  She additionally serves on the Society of Critical Care Medicine’s Ethics Committee.  Specific interests include organ donation, issues surrounding the determination of death, and technology dependence in critically ill children.Ásdís Finnsdóttir Wagner, DOÁsdís Finnsdóttir Wagner, DO, is a pediatric intensivist at Children’s Mercy in Kansas City. She is a graduate of the Pediatric Bioethics Certificate Program at Children’s Mercy Center for Bioethics and has conducted research on end-of-life issues and communication within the pediatric intensive care unit. She isan active member of the Ethics Committee at Children’s Mercy. She is currently Assistant Professor of Pediatrics at University of Missouri in Kansas City and serves as Educational Liaison for resident and medical student education within the critical care department.John Lantos, MDJohn Lantos, MD, is a general pediatrician and bioethicist. He has served as President of both the American Society of Bioethics and Humanities and the American Society of Law Medicine and Ethics. He has also held many leadership positions in the American Academy of Pediatrics.  He was a member of President Clinton’s health reform task force in 1993 and a consultant to President Bush’s Bioethics Council.  He has published hundreds of peer-reviewed articles and many books, including The Lazarus Case, Neonatal Bioethics, and Do We Still Need Doctors? He is currently Director of a Pediatric Bioethics Center and Children’s Mercy Hospital and Professor of Pediatrics at University of Missouri in Kansas City.

“This book is specifically intended for care providers … also benefit ethics consultants or students looking for a concise book on the ethical issues in pediatric critical care. … This would be a welcome resource for providers or other scholars engaged in the care of critically ill children. It offers a concise and well-researched treatment of ethical issues that arise in the pediatric ICU and provides practical guidance for those working in the field.” (Annie B. Friedrich, Doody's Book Reviews, 27 September, 2019)

• 1. Intro and overview of a clinical ethics framework for decisions in pediatric critical care.- 2. The epidemiology of life-threatening illness in childhood.- 3. End-of-life discussions in the PICU.- 4. Medical Futility.- 5. Children as Organ Donors.- 6. Controversies about Brain Death.- 7. Moral Distress.- 8. Resource allocation in the PICU.