Recognition of ethical issues in everyday clinical
practice
The key areas and issues that
arise frequently in paediatric practice are summarized in Box 31.1.
·
Age
and Gillick/Fraser competence
·
Parental
consent or refusal
·
Proxy
consent
·
Refusal
of treatment
·
Insistence
on treatment
·
Aggressive
treatment
·
Resuscitation
and do-not-resuscitate orders
·
Refusal
of treatment by doctors
·
Cultural
factors (e.g. circumcision, blood transfusion in Jehovah’s Witness)
·
The
doctor–patient relationship
·
Rights
of minors with or without competence
·
Rights
of the child versus the family
·
Rights
of parents
·
Resuscitation
·
Withholding
and withdrawing treatment and end-of-life decisions
·
Duties
of the doctor and breaching confidentiality
Conflicts of interest: general
practitioner’s duties to the family
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