Episode 42: The Ethical Dilemma

Where do ethics and palliative care overlap, and is there really no harm in doing both? Exercise your autonomy by choosing to listen to this episode, in which your beneficent hosts, Sarah and Dan, get ethical with Phoebe Winn and Bob Macauley, both palliative care physicians whose careers have also brought them to the realm of questions that sometimes just don't have answers. Thankfully, our expert guests are here to help us all understand. I mean, it would hardly be worth listening to if it were just us, right?

Phoebe Winn's recommended ethics readings (click the PMID's for links):

1. Diekema DS. Parental refusals of medical treatment: the harm principle as threshold for state intervention. Theor Med Bioeth. 2004;25(4):243-64. doi: 10.1007/s11017-004-3146-6. PMID: 15637945. 
2. Kon AA. Informed non-dissent: a better option than slow codes when families cannot bear to say "let her die". Am J Bioeth. 2011 Nov;11(11):22-3. doi: 10.1080/15265161.2011.603796. PMID: 22047119.
3. Mercurio MR, Cummings CL. Critical decision-making in neonatology and pediatrics: the I-P-O framework. J Perinatol. 2021 Jan;41(1):173-178. doi: 10.1038/s41372-020-00841-6. Epub 2020 Sep 30. PMID: 32999448.
4. Diekema DS. Adolescent Brain Development and Medical Decision-making. Pediatrics. 2020 Aug;146(Suppl 1):S18-S24. doi: 10.1542/peds.2020-0818F. PMID: 32737228.
5. Diekema DS, Botkin JR; Committee on Bioethics. Clinical report--Forgoing medically provided nutrition and hydration in children. Pediatrics. 2009 Aug;124(2):813-22. doi: 10.1542/peds.2009-1299. Epub 2009 Jul 27. PMID: 19651596.
6. Taub S, Macauley R; COMMITTEE ON BIOETHICS. Responding to Parental Requests for Nondisclosure to Patients of Diagnostic and Prognostic Information in the Setting of Serious Disease. Pediatrics. 2023 Oct 1;152(4):e2023063754. doi: 10.1542/peds.2023-063754. PMID: 37743818.
7. Really all the AAP Bioethics Guidelines are helpful to know about: https://publications.aap.org/pediatrics/collection/528/Committee-on-Bioethics

And, in case you missed it in Episode 40, Bob Macauley's fabulous new book about his career in palliative care and ethics:  Because I Knew You