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Pediatricians Face Wide Range of Ethics Issues

Balancing rights of patients and parents can be a challenge to quality care

WEDNESDAY, Sept. 9 (HealthDay News) -- Pediatric residents may face ethics challenges that are wide-ranging and pose a challenge to patient care, according to a study in the September issue of the Archives of Pediatrics & Adolescent Medicine.

Margaret Moon, M.D., of the Johns Hopkins School of Medicine in Baltimore, and colleagues directly observed interactions between 15 pediatric faculty preceptors and 50 pediatric residents on duty during 19 half-day clinic sessions to identify the ethics content of cases.

The researchers found that ethics challenges included how to best promote the child's interests in deprived home and social settings; protecting patient confidentiality; proper use of professional authority; balancing the dual roles of health care provider and learner; and the challenge of managing the therapeutic alliance with parents and other caregivers. They further note that direct observation had advantages over generated recall and surveys.

"This approach identified the individual trainees' specific ethics experiences in an educational setting. In this way, we were able to capture the complexity of 'everyday' ethics in a busy teaching clinic," the authors write. "Competence in ethics is part of good clinical practice. Understanding the specific content of ethics experiences can help focus educational efforts on the skills necessary to identify, analyze, and manage ethics issues arising in everyday practice."

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