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OBJECTIVE Describe the roles and respective responsibilities of PICU healthcare professionals in end-of-life care decisions faced by PICU parents. DESIGN Retrospective qualitative study. SETTING University-based tertiary care children's hospital. PARTICIPANTS Eighteen parents of children who died in the pediatric ICU and 48 PICU healthcare(More)
BACKGROUND Parent refusal or deliberate delay of their child's vaccinations poses a challenge for pediatricians. Some pediatricians may choose to dismiss these families from their practice. OBJECTIVES To describe pediatricians' responses to scenarios of vaccine refusal, identify reasons pediatricians cite for both parent refusal and family dismissal, and(More)
We review the controversies surrounding the management of patients born with ambiguous genitalia to determine the strengths and weaknesses of recommendations for clinical practice. Traditional practice involves paternalistic decision making by medical practitioners, including the use of deception and/or incomplete communication of facts about the infant's(More)
BACKGROUND Data about pediatric intensive care unit (PICU) family conferences (FCs) are needed to enhance our understanding of the role of FCs in patient care and build a foundation for future research on PICU communication and decision making. OBJECTIVE The study's objective was to describe the use and content of PICU FCs. DESIGN The study design was a(More)
The current state of organ procurement and the ethical issues raised by the procurement process are reviewed in this article. After an examination of the legislative framework governing organ procurement, the intensivist's role in donation is discussed, including (1) donor identification, (2) asking the family to donate, and (3) obtaining consent. Recent(More)
CONTEXT Although authoritative bodies have promulgated guidelines for donation after cardiac death (DCD) and the Joint Commission requires hospitals to address DCD, little is known about actual hospital policies. OBJECTIVE To characterize DCD policies in children's hospitals and evaluate variation among policies. DESIGN, SETTING, AND PARTICIPANTS(More)
The authors explain that several years of effort, by many faculty from a variety of disciplines, were required to expand medical ethics teaching at the University of Pittsburgh School of Medicine beyond the preclinical years. Since 1986, faculty associated with the school's Center for Medical Ethics have begun a comprehensive ethics teaching program for all(More)