When should we use extraordinary means to save a child rather than letting nature take its course? Should we treat otherwise healthy short children with growth hormone to make them taller? How do we draw the line between appropriate uses of stimulant medications and inappropriate ones? What is the best approach to a child born with ambiguous genitalia?
These are the kinds of questions that John Lantos, MD, Director of Pediatric Bioethics, Professor of Pediatrics, University of Missouri-Kansas City School of Medicine, is tackling as head of the new Children’s Mercy Bioethics Center. The Center was created to assist health care providers, patients and families who are working through the challenging issues that invariably accompany significant medical progress.
“We always start with the question ‘What is best for the child?’ The tough cases are the ones where there isn’t a clear answer. My role at Children’s Mercy is to help staff and families make difficult, ethical decisions. The focus will always be on the best possible outcomes, both ethically and medically, for our patients.”
Ethical decision making in pediatrics is especially challenging because the patients themselves are either too young to participate at all in decisions or else have limited life experiences and are developmentally unprepared or unable to make decisions about their care. When the patient is a competent adult, the focus of bioethical deliberations is always on the patient’s own preferences for treatment. In pediatrics, we cannot rely on patient autonomy to drive decisions.
“The Children’s Mercy Bioethics Center will serve as an advocate for our patients when they cannot speak for themselves. It will serve as an advisor to doctors and nurses. And we will do research and write papers to help others around the country who are wrestling with these issues. Children’s Mercy has a renowned reputation for serving in that role, and the Center will continue that tradition,”
Additionally, the Bioethics Center will develop educational programs for physicians and other health professionals at Children’s Mercy. Dr. Lantos will work to create a national center of excellence for pediatric bioethics.
“The overall goal is to improve the way care is provided for all of our children. Children’s Mercy is a national leader in pediatrics. The Bioethics Center will be one more way that we can serve both our community and children throughout the United States.”