Overview of Pediatric Ethics and Palliative Care (DRAFT)

Significant differences exist between adult and pediatric palliative care, including distinct diagnoses, divergent trajectories of illness, unique aspects of treatment, unique social contexts, and the simple fact that “children aren’t supposed to die.” Similarly, pediatric ethics is distinct from adult ethics by virtue of the shifted locus of decision-making, the lack of choice of one’s surrogate, the prevalence of the best interest standard, and the triadic clinical relationship. A more helpful paradigm by which to evaluate the appropriateness of parental decision-making is the harm principle, which recognizes the greater latitude granted to parents (compared to other surrogates) in deciding for the patient.