Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T08:57:03.432Z Has data issue: false hasContentIssue false

Chapter 16 - Paediatric Neurosurgery

from Part II - Neurosurgery-Specific Bioethics

Published online by Cambridge University Press:  29 May 2020

Stephen Honeybul
Affiliation:
Sir Charles Gairdner Hospital, Royal Perth and Fiona Stanley Hospitals
Get access

Summary

A thorough understanding of ethical issues, which are often encountered in the field of paediatric neurosurgery, can help neurosurgeons in decision-making regarding optimal treatment in children. Although ethical dilemmas in paediatric neurosurgical patients frequently share common characteristics with those seen in the management of adult patients, they also differ and are more complex. For example, because child patients do not have the ability to make decisions on their own due to their age, their parents are usually substitute decision makers. Ethical problems in paediatric neurosurgery may arise with prenatal diagnosis and continue to be encountered in various age groups with different characteristics during foetal, neonatal, infancy, playschool age, school age, and adolescence. Moreover, intrauterine foetal life involves the health and wellbeing of the mother, further complicating ethical decision-making. Collaborative communication and the exchange of information between the medical team and the family, which leads to a shared family-centered decision-making, are an increasingly preferred approach to paediatric medical decision-making. In addition, developmental maturation of the child allows for increasing longitudinal inclusion of the child’s opinion in medical decision-making in clinical and research practice. The child should always be informed in a respectful manner and using simple language adjusted to the childs age. Despite the limits of medicine at a specific time, clinicians should always respect a child with an incurable disease and show warm sympathy toward babies born with the fate of a short life.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Yamasaki, M. Life and medical ethics in pediatric neurosurgery. Neurol. Med. Chir. (Tokyo) 2017; 57: 1015.Google Scholar
McDonald, P., Gupta, N., Peacock, W. Ethical issues in pediatric neurosurgery. In Principles and Practice of Pediatric Neurosurgery, 2nd ed., Albright, A. L., Adelson, P. D., Pollack, I. F., eds. New York: Thieme; 2008.Google Scholar
McLone, D. G. The diagnosis, prognosis, and outcome for the handicapped newborn: a neonatal view. Issues Law Med. 1986; 2: 1524.Google Scholar
Ingraham, F. D., Matson, D. D. Neurosurgery of Infancy and Childhood. Springfield, IL, Charles C. Thomas, 1954.CrossRefGoogle Scholar
Lorber, J. Selective treatment of myelomeningocele: To treat or not to treat? Pediatrics 1974; 53: 3078.Google Scholar
Taylor, A., Butt, W., Rosenfeld, J., et al. A randomised trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension. Childs Nerv. Syst. 2001; 17: 15462.Google Scholar
Adzick, N. S., Thom, E. A., Spong, C. Y., et al. MOMS Investigators. A randomised trial of prenatal versus postnatal repair of myelomeningocele. N. Engl. J. Med. 2011; 364: 9931004.Google Scholar
Verhagen, E., Sauer, P. J. The Groningen protocol: euthanasia in severely ill newborns. N. Engl. J. Med. 2005; 352: 95962.CrossRefGoogle ScholarPubMed
Nakagawa, T. A., Ashwal, S., Mathur, M., et al. Committee for Determination of Brain Death in Infants’ guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations – executive summary. Ann. Neurol. 2012; 71: 57385.CrossRefGoogle ScholarPubMed
Katz, A. L., Webb, S. A. Committee on bioethics. Informed consent in decision-making in pediatric practice. Pediatrics 2016; 138(2).CrossRefGoogle ScholarPubMed
Barry, S. Quality of life and myelomeningocele: an ethical and evidence-based analysis of the Groningen Protocol. Pediatr. Neurosurg. 2010; 46: 40914.CrossRefGoogle ScholarPubMed
Cote, D. J., Balak, N., Brennum, J., et al. Ethical difficulties in the innovative surgical treatment of patients with recurrent glioblastoma multiforme. J. Neurosurg. 2017; 126: 204550.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×