Ethical dilemmas in pediatric and adolescent psychogenic nonepileptic seizures

Abstract

To date only a very narrow window of ethical dilemmas in psychogenic non-epileptic seizures (PNES) have been explored. Numerous distinct ethical dilemmas arise in diagnosing and treating pediatric and adolescent patients with PNES. Important ethical values at stake include trust, transparency, confidentiality, professionalism, autonomy of all stakeholders and justice. In order to further elucidate the ethical challenges in caring for this population, an ethical analysis of the special challenges faced in four specific domains is undertaken: (1) conducting and communicating a diagnosis of PNES; (2) advising patients about full transparency and disclosure to community including patients’ peers; (3) responding to requests to continue anti-epileptic drugs; and (4) managing challenges arising from school policy and procedure. An analysis of these ethical issues is essential for the advancement of best care practices that promote the overall well-being of patients and their families.

Les enjeux éthiques de la pratique de l’ergothérapie : perceptions d’ergothérapeutes

“…Tandis que les enjeux éthiques que soulève la pratique de la médecine (Cole, Falcone, Caplan, Timmons-Mitchell, Jares, & Ford, 2014;Messner & Gentili, 2011;Miller, Siegler, & Angelos, 2014;Pellegrini & Ferreres, 2014;Sansom, 2014;Tocker & Salzer, 2012) ou des sciences infirmières (Austin, 2012;Burston & Tuckett, 2012;Dekeyser & Berkovitz, 2012;Eran, 2014;Holm & Severinsson, 2014;Jameton, 2013;Manara, Villa, & Moranda, 2014) sont o 2, pp. 166-196. 168 abondamment documentés, ceux que pose la pratique de l'ergothérapie sont, à ce jour, peu étudiés (Bushby, Chan, Druif, Ho, & Kinsella, 2015).…”

Semiological and psychiatric characteristics of children with psychogenic non-epileptic seizures

“…wody z odpowiednim wyjaśnieniem, że taki "lek" może spowodować wystąpienie charakterystycznych dla danego chorego objawów, czyli wykorzystanie podatności na sugestię [21]. Poważnym problemem jest też odpowiednie przedstawienie diagnozy i zaproponowanie odpowiedniego postepowania u chorych w wieku rozwojowym [22].…”

Psychogenic Nonepileptic Seizures in Patients Living with Neurocysticercosis

“…Significant mental health, social, and community resources are frequently necessary to effectively treat this patient population, but these resources are scarce. To ensure a successful management of PNES, all ethical values should be taken in to consideration from the first clinic [122][123][124][125][126].…”