Intersex in the Age of Queer Bioethics

Queer Bioethics and the inventory of its potential populations include a wide range of queer subjects: lesbian parents, HIV-positive gay and bisexuals, transgender youth, and non-cisgendered individuals, to name a few. With the ethical dilemmas and ethical duties couched inside of a Queer Bioethics in mind, this article will consider one of the field’s most enduring citizens: the intersex child. More specifically, the figure of the intersex child with ovotesticular non-normativity will be scrutinized on ethical and clinical planes – a major aspect of queer bioethics is, after all, clinical ethics for queer populations. Ovotesticular conditions will be covered at length; we discuss different variations in addition to narrowing the topic to those with 46,XX and ambiguous genitalia, specifically those 75% diagnosed under the age of 20, and speak on issues related to this population. We will also briefly discuss the population of the 20% diagnosed under the age of 5 years old. Interventions will be discussed in all realms of intersex conditions – specifically ovotestes. We will conclude with a principalist approach to ethical topics such as autonomy, beneficence, and non-maleficence, weighing these principles equally and ultimately erring on the side of autonomy within pediatric ethics where possible.

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.

What do new neuroscience discoveries in children mean for their open future?

Over the last decade, the number of neuroimaging and other neuroscience studies on the developing brain from fetal life through adolescence has increased exponentially. Children are viewed as particularly vulnerable members of our society and observations of significant neural structural changes associated with behavioral anomalies raise numerous ethical concerns around personal identity, free will, and the possibility of an open future. This chapter provides a review of recent research in the pediatric neuroscience literature, common pediatric decision-making, and social justice models, and discusses the implications of this research for the future of pediatric ethics thinking and policy. New research presents challenges to professional and pediatric bioethicist views of the moral future of children in pediatric healthcare and opportunities to examine anew notions of how to consider the developing moral agency of children.