Acquiescence is Not Agreement: The Problem of Marginalization in Pediatric Decision Making. Issue 6 (3rd June 2022)

• Record Type: Journal Article
• Authors: Caruso Brown, Amy E.
• Is Part Of: American journal of bioethics. Volume 22:Issue 6(2022)
• Page Start: 4
• Page End: 16
• Publication Date: 2022-06-03
• Subjects: Children and families decision making pediatrics informed consent; Bioethics -- Periodicals; Medical ethics -- Periodicals; 174.957
• DOI: 10.1080/15265161.2021.1887964
• Languages: English
• ISSNs: 1526-5161

Abstract

Abstract: Although parents are the default legal surrogate decision-makers for minor children in the U.S., shared decision making in a pluralistic society is often much more complicated, involving not just parents and pediatricians, but also grandparents, other relatives, and even community or religious elders. Parents may not only choose to involve others in their children's healthcare decisions but choose to defer to another; such deference does not imply agreement with the decision being made and adds complexity when disagreements arise between surrogate decision-makers for minor children and their physicians. I argue that clinicians and ethicists have a duty to consider voices marginalized by hierarchical structures, including but not limited to gender-based inequalities. This approach involves negotiating potential conflicts: between respecting differences of culture and religion, on one hand, and assuring that the wishes of those who are most invested in children's lives are considered, on the other.