Bioethical Boundaries, Critiques of Current Paradigms, and the Importance of Transparency

Parker, Joseph C.

doi:10.1093/jmp/jhab042

Cited by 2 publications

(3 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Provide full transparency to all patients regarding the maternal‐fetal care team's recommendations for their care, based upon the existing predetermined criteria, the care team's process for ad hoc changes, and the patient's own desires to undergo maternal‐fetal therapy, if present 43 …”

Section: Recommendationsmentioning

confidence: 99%

“…Provide full transparency to all patients regarding the maternalfetal care team's recommendations for their care, based upon the existing predetermined criteria, the care team's process for ad hoc changes, and the patient's own desires to undergo maternalfetal therapy, if present. 43 Specifically, points #3, 6, 7, 8 can be tracked and measured on a regular basis (annually or more frequently) as a form of quality control for a maternal-fetal intervention center. We argue that this approach is a bioethically justified method for determining eligibility for maternal-fetal inventions as it supports nonmaleficence, beneficence and justice towards the pregnant person and the fetus.…”

Section: Recommendationsmentioning

confidence: 99%

“…This could utilize a pre‐defined multidisciplinary oversight committee or other similar kind of committee as some have recommended 41,42 Regularly review predetermined criteria, taking into consideration center‐specific experiences, new literature, and input from other centers with particular attention to evidence of bias and/or inconsistencies. Develop a structured approach to evaluating situations that commonly arise in maternal‐fetal care so that similar concerns can be considered in a regimented fashion. Support an open, egalitarian environment to enable members of the team to help define the circumstances under which particular maternal‐fetal interventions would be offered—based on skills, expertise, and resources available—to allow for coordinated decision‐making. Ensure established processes to allow for assessing team disagreements about a given case prior to discussing the resulting recommendations with a patient. Regularly review limitations of available evidence informing recommendations for care, based on a predefined frequency. Provide full transparency to all patients regarding the maternal‐fetal care team's recommendations for their care, based upon the existing predetermined criteria, the care team's process for ad hoc changes, and the patient's own desires to undergo maternal‐fetal therapy, if present 43 …”

Section: Recommendationsmentioning

confidence: 99%

See 2 more Smart Citations

The value and limitations of using predetermined criteria in decision making for maternal‐fetal interventions

et al. 2023

View full text Add to dashboard Cite

Maternal-fetal interventions-such as prenatal fetal myelomeningocele (MMC)repair-are at the forefront of clinical innovation within maternal-fetal medicine, pediatric surgery, and neonatology. Many centers determine eligibility for innovative procedures using pre-determined inclusion and exclusion criteria based on seminal studies, for example, the "Management of Myelomeningocele Study" for prenatal MMC repair. What if a person's clinical presentation does not conform to predetermined criteria for maternal-fetal intervention? Does changing criteria on a case-by-case basis (i.e., ad hoc) constitute an innovation in practice and flexible personalized care or transgression of commonly held standards with potential negative consequences? We outline principle-based, bioethically justified answers to these questions using fetal MMC repair as an example. We pay special attention to the historical origins of inclusion and exclusion criteria, risks and benefits to the pregnant person and the fetus, and team dynamics. We include recommendations for maternal-fetal centers facing these questions. Key points What's already known about this topic?� Though trial-based data form the basis of recommendations for maternal-fetal interventions, other information and clinicians' views, both of which may be subject to multiple biases, are commonly incorporated. What does this review add?� Ethical justification for including other information and clinicians' views when predetermined eligibility criteria exist for maternal-fetal interventions.� Recommendations for how maternal-fetal care centers should include processes for ad-hoc exceptions and regular review of predetermined criteria for maternal-fetal interventions to uphold the bioethical principles of maternal autonomy and nonmaleficence.

show abstract

Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

The value and limitations of using predetermined criteria in decision making for maternal‐fetal interventions

et al. 2023

View full text Add to dashboard Cite

show abstract

Building the bioethics tools of a community council to the future: the ecosystemic gap

LeBlanc

2023

Humanit Soc Sci Commun

View full text Add to dashboard Cite

These are times of crisis. Recently, the COVID-19 pandemic and the resurgence of a form of Cold War raised international concerns about Health & Well-Being, Climate & Biodiversity, and Technology & Economy. Articulating bridges between disciplines, between cultures and between knowledges has never been more urgent to accelerate the translation of values and policies into actions. This comprehensive review argues for a radical ecosystemic approach to bridge the Medical & Environmental fields (studies, sectors, and technics) in an integrated management practice of Care, Production & Biodiversity. As bridging implies solving the epistemological gap, the argument emphasizes the need to raise awareness with theoretical hybridizations, fieldwork hypotheses, and working theories. According to Van Rensselaer Potter, who coined the term ‘bioethics’, awareness means to refocus the Medical & Environmental studies and surveillance processes from a target (e.g., the disease, the pathogen, or the resource) to its context (e.g., adding history, demography and ecology). Thus reframed, concerned researchers, leaders, and citizens should invest their effort in preparing the (contextual) terrain for ever-more organizational resilience. We conclude on the need for actions to shape the Health & Biodiversity determinants, to improve communication systems, data-sharing networks, and responsible innovations, and to foster knowledge translation to envision a better realistic future. “Ecology’s uneconomic, but with another kind of logic economy’s unecologic” (Potter 1988, p.9)

show abstract

Bioethical Boundaries, Critiques of Current Paradigms, and the Importance of Transparency

Cited by 2 publications

References 33 publications

The value and limitations of using predetermined criteria in decision making for maternal‐fetal interventions

The value and limitations of using predetermined criteria in decision making for maternal‐fetal interventions

Building the bioethics tools of a community council to the future: the ecosystemic gap

Contact Info

Product

Resources

About