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Ethics in paediatric palliative care 

Ethics in paediatric palliative care
Ethics in paediatric palliative care
Oxford Textbook of Palliative Medicine (5 ed.)

Richard D.W. Hain


Professional competence is a necessary but insufficient representation of how an individual health-care professional should properly behave in relation to a patient. Medical ethics addresses the further question of the basis on which actions taken by professionals in the context of that relationship are morally right. Children are distinct from adults in ethically relevant ways. They lack autonomy, both in practice and in principle, and their interests are easily ignored or annexed to others. In practice, ethical questions in children are currently addressed using the ‘four-principles’ or by appealing to rights-based arguments. Behind both are ethical theories (particularly deontology, utilitarian consequentialism, and virtue ethics) that are important, but problematic, in children. This chapter reviews existing ways of looking at ethics in end-of-life care for children, considering three specific contemporary debates in medical ethics in children’s palliative care: the principle of double effect, euthanasia, and withholding or withdrawal of life-sustaining treatment.

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