Ethical care of the critically ill child: a conception of a 'thick' bioethics.
In this article I argue for an interpretive approach to bioethics with critically ill children. I begin by highlighting the dominant Anglo-American bioethical framework that defines standards for ethical care in critically ill children and then outline a critique of this framework. Drawing predominantly on the ideas of Charles Taylor, Michael Walzer and Richard Zaner, I call for a reconception of bioethics and propose an interpretive 'thick' framework that is centred on culture and context. Finally, I illustrate this interpretive approach through a comparative study of two cases in pediatric intensive care: the narratives of Marc and Larry. These case studies reveal that ethical dilemmas in pediatric critical care can be traced to relational tensions over respect, trust and power rooted in the disparity of moral horizons among the persons involved.
Carnevale
Franco A
FA
Montreal Children's Hospital, Montreal, Quebec, Canada H3H 1P3. frank.carnevale@muhc.mcgill.ca
D001291:Attitude of Health Personnel; D002648:Child; D002669:Child Welfare / Q000941:ethics*; D016638:Critical Illness / Q000451:nursing; D026689:Ethical Analysis; D028663:Ethical Theory; D026690:Ethics, Clinical; D004992:Ethics, Medical; D004993:Ethics, Nursing; D006801:Humans; D015278:Intensive Care Units, Pediatric; D033262:Narration; D010290:Parents / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000941:ethics