Robert Macauley
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View article: “Mr. Smith Has No Mealtimes”: Minimal Comfort Feeding for Patients with Advanced Dementia
“Mr. Smith Has No Mealtimes”: Minimal Comfort Feeding for Patients with Advanced Dementia Open
While Comfort Feeding Only is appropriate for patients with advanced dementia, its emphasis on assiduous hand-feeding that may prolong life for years fails to accommodate the preferences of those who do not want to continue living with thi…
View article: Epileptologists infrequently discuss the risk of intubation with patients with epilepsy in the United States
Epileptologists infrequently discuss the risk of intubation with patients with epilepsy in the United States Open
Epileptologists infrequently discuss the risk of intubation and mechanical ventilation with patients with epilepsy. Many felt that such discussions are unnecessary with most patients, but also best led by a neurologist. Neurologists with e…
View article: Ethical Considerations in Pediatricians’ Use of Social Media
Ethical Considerations in Pediatricians’ Use of Social Media Open
Increasing use of social media by patients and clinicians creates opportunities as well as dilemmas for pediatricians, who must recognize the inherent ethical and legal complexity of these communication platforms and maintain professionali…
View article: POLST Signature Requirements: Responding With Compassion While Ensuring Informed Consent
POLST Signature Requirements: Responding With Compassion While Ensuring Informed Consent Open
The majority of states require the signature of a surrogate decision maker on a POLST form for a patient who lacks decisional capacity. While commendable in its intention to ensure informed consent, in some cases this may lead the surrogat…
View article: Diagnosis, Management, and Treatment of Female Genital Mutilation or Cutting in Girls
Diagnosis, Management, and Treatment of Female Genital Mutilation or Cutting in Girls Open
Female genital mutilation or cutting (FGM/C) involves medically unnecessary cutting of parts or all of the external female genitalia. It is outlawed in the United States and much of the world but is still known to occur in more than 30 cou…
View article: Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force
Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force Open
The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institutio…
View article: Children With Intellectual and Developmental Disabilities as Organ Transplantation Recipients
Children With Intellectual and Developmental Disabilities as Organ Transplantation Recipients Open
The demand for transplantable solid organs far exceeds the supply of deceased donor organs. Patient selection criteria are determined by individual transplant programs; given the scarcity of solid organs for transplant, allocation to those…
View article: Fertility Preservation for Pediatric and Adolescent Patients With Cancer: Medical and Ethical Considerations
Fertility Preservation for Pediatric and Adolescent Patients With Cancer: Medical and Ethical Considerations Open
Many cancers presenting in children and adolescents are curable with surgery, chemotherapy, and/or radiotherapy. Potential adverse consequences of treatment include sterility, infertility, or subfertility as a result of gonad removal, dama…
View article: Guidance on Forgoing Life-Sustaining Medical Treatment
Guidance on Forgoing Life-Sustaining Medical Treatment Open
This Policy Statement was reaffirmed June 13, 2023. Pediatric health care is practiced with the goal of promoting the best interests of the child. Treatment generally is rendered under a presumption in favor of sustaining life. However, in…