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https://www.readbyqxmd.com/read/29209695/cosmetic-surgery-for-children-and-adolescents-deontological-and-bioethical-remarks
#1
A Del Rio, R Rinaldi, S Napoletano, N M di Luca
The only interventions deemed ethically acceptable are those that serve the "objective interest" of the minors involved from the standpoint of and conducive to sound mental health and balance in a patient's teenage years; by the same token, disproportionate interventions (e.g. overly invasive or pointlessly risky), or all those deemed unsuitable with regards to a poor cost-benefit ratio are viewed as unacceptable. In the process of considering the best interest of the minors involved, a wide array of factors come into play, such as: age, maturity, psychological and emotional conditions, motivations put forth by the underage patient, the opportunity to procrastinate the operation: parents, who are naturally entitled to give consent to the surgical procedures, and physicians are primarily liable to safeguard and act in the minor's best interest...
November 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29190346/broad-support-for-regulating-the-clinical-implementation-of-future-reproductive-techniques
#2
S Hendriks, R Vliegenthart, S Repping, E A F Dancet
STUDY QUESTION: Do gynaecologists, infertile patients and the general public, consider that regulation of the clinical implementation of stem cell-based fertility treatments is required? SUMMARY ANSWER: There is broad support from gynaecologists, patients and the general public for regulating the clinical implementation of future stem cell-based fertility treatments. WHAT IS KNOWN ALREADY: There is debate on the need to regulate the clinical implementation of novel techniques...
November 28, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29111941/reasons-to-amplify-the-role-of-parental-permission-in-pediatric-treatment
#3
Mark Christopher Navin, Jason Adam Wasserman
Two new documents from the Committee on Bioethics of the American Academy of Pediatrics (AAP) expand the terrain for parental decision making, suggesting that pediatricians may override only those parental requests that cross a harm threshold. These new documents introduce a broader set of considerations in favor of parental authority in pediatric care than previous AAP documents have embraced. While we find this to be a positive move, we argue that the 2016 AAP positions actually understate the importance of informed and voluntary parental involvement in pediatric decision making...
November 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29025837/effects-of-lactobacillus-rhamnosus-gg-and-bifidobacterium-lactis-bb12-on-beta-cell-function-in-children-with-newly-diagnosed-type-1-diabetes-protocol-of-a-randomised-controlled-trial
#4
Lidia Groele, Hania Szajewska, Agnieszka Szypowska
INTRODUCTION: Recent evidence has demonstrated that, among other factors, dysbiosis (imbalances in the composition and function of the gut microbiota) may be relevant in the development of type 1 diabetes (T1D). Thus, gut microbiota may be a target for improving outcomes in subjects with T1D. The aim of the study is to examine the effects of Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 on beta-cell function in children with newly diagnosed T1D. METHODS AND ANALYSIS: A total of 96 children aged 8 to 17 years with newly diagnosed T1D, confirmed by clinical history and the presence of at least one positive autoantibody, will be enrolled in a double-blind, randomised, placebo-controlled trial in which they will receive L...
October 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28947504/medical-and-bioethical-considerations-in-elective-cochlear-implant-array-removal
#5
Maryanna S Owoc, Elliott D Kozin, Aaron Remenschneider, Maria J Duarte, Ariel Edward Hight, Marjorie Clay, Susanna E Meyer, Daniel J Lee, Selena Briggs
OBJECTIVE: Cochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation. DATA SOURCES: We address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community...
September 25, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28945637/serum-hepcidin-in-children-with-inflammatory-bowel-disease
#6
Paulina Krawiec, Agnieszka Mroczkowska-Juchkiewicz, Elżbieta Pac-Kożuchowska
BACKGROUND: Hepcidin is a major regulator of iron homeostasis and a mediator of innate immunity. To date, the role of hepcidin in inflammatory bowel disease (IBD) children is not clearly established. We aimed to assess serum hepcidin concentration in IBD children and correlate hepcidin with iron status parameters and inflammatory markers. METHODS: The study group included 46 pediatric patients with ulcerative colitis and 29 with Crohn's disease. In control group, there were 21 children with functional gastrointestinal disorders...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28943969/the-right-to-know-and-the-right-not-to-know-revisited-part-one
#7
Roger Brownsword, Jeff Wale
Prompted by developments in human genetics, a recurrent bioethical question concerns a person's 'right to know' and 'right not to know' about genetic information held that is intrinsically related to or linked to them. In this paper, we will revisit the claimed rights in relation to two particular test cases. One concerns the rights of the 500,000 participants in UK Biobank (UKB) whose biosamples, already having been genotyped, will now be exome sequenced, and the other concerns the rights of pregnant women (and their children) who undergo non-invasive prenatal testing (NIPT)-a simple blood test that can reveal genetic information about both a foetus and its mother...
2017: Asian Bioethics Review
https://www.readbyqxmd.com/read/28873213/bioethics-children-and-the-environment
#8
Timothy F Murphy
Queer perspectives have typically emerged from sexual minorities as a way of repudiating flawed views of sexuality, mischaracterized relationships, and objectionable social treatment of people with atypical sexuality or gender expression. In this vein, one commentator offers a queer critique of the conceptualization of children in regard to their value for people's identities and relationships. According to this account, children are morally problematic given the values that make them desirable, their displacement of other beings and things entitled to moral protection, not to mention the damaging environmental effects that follow in the wake of population growth...
September 5, 2017: Bioethics
https://www.readbyqxmd.com/read/28852938/medicalising-short-children-with-growth-hormone-ethical-considerations-of-the-underlying-sociocultural-aspects
#9
Maria Cristina Murano
In 2003, the Food and Drug Administration approved the use of growth hormone treatment for idiopathic short stature children, i.e. children shorter than average due to an unknown medical cause. Given the absence of any pathological conditions, this decision has been contested as a case of medicalisation. The aim of this paper is to broaden the debate over the reasons for and against the treatment, to include considerations of the sociocultural phenomenon of the medicalisation of short stature, by means of a critical understanding of the concept of medicalisation...
August 29, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28724001/food-marketing-targeting-children-unveiling-the-ethical-perspectives-in-the-discourse-on-self-regulation
#10
Dillian Adelaine Cesar da Silva, Antonio Carlos Rodrigues da Cunha, Thiago Rocha da Cunha, Caroline Filla Rosaneli
When it comes to food marketing, children are one of the major targets. Regulatory actions can play a strategic role in health protection. The objective of this research was to characterize the ethical perspective in the discourse against state regulatory actions on food marketing directed at children, aiming to understand the context of the discourse's production and how it creates meaning. The methodology adopted was qualitative, with documentary analysis and use of concepts and procedures from Discourse Analysis...
July 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28716389/biomedical-ethics-and-clinical-oversight-in-multisite-observational-neuroimaging-studies-with-children-and-adolescents-the-abcd-experience
#11
REVIEW
Duncan B Clark, Celia B Fisher, Susan Bookheimer, Sandra A Brown, John H Evans, Christian Hopfer, James Hudziak, Ivan Montoya, Margaret Murray, Adolf Pfefferbaum, Deborah Yurgelun-Todd
Observational neuroimaging studies with children and adolescents may identify neurological anomalies and other clinically relevant findings. Planning for the management of this information involves ethical considerations that may influence informed consent, confidentiality, and communication with participants about assessment results. Biomedical ethics principles include respect for autonomy, beneficence, non-maleficence, and justice. Each project presents unique challenges. The Adolescent Brain and Cognitive Development study (ABCD) collaborators have systematically developed recommendations with written guidelines for identifying and responding to potential risks that adhere to biomedical ethics principles...
June 28, 2017: Developmental Cognitive Neuroscience
https://www.readbyqxmd.com/read/28665917/brief-psychosis-induced-by-methylphenidate-in-a-child-with-attention-deficit-disorder-a-case-report-and-literature-review
#12
Juan Carlos Martínez-Aguayo, Marcelo Arancibia, Nicolás Meza-Concha, Camila Bustamante, Javier Pérez-Bracchiglione, Eva Madrid
Methylphenidate-induced psychosis has been scarcely studied due to bioethical and neurobiological issues regarding its research. Although some authors have hypothesized that there might be a vulnerability for the development of a major psychiatric disorder in the long term, there is no agreement about the predictive value of this type of psychosis in children and adolescents, and its origin is also uncertain. It has been suggested that higher dopamine levels in some cerebral regions and a family history of mental disorders might increase the risk of psychosis secondary to psychostimulants...
June 21, 2017: Medwave
https://www.readbyqxmd.com/read/28638969/introduction-childhood-and-disability
#13
EDITORIAL
Erica K Salter
From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care...
June 21, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28577266/reimagining-childhood-responding-to-the-challenge-presented-by-severe-developmental-disability
#14
Erica K Salter
Through an exploration of the experience of severe and profound intellectual disability, this essay will attempt to expose the predominant, yet usually obscured, medical anthropology of the child and examine its effects on pediatric bioethics. I will argue that both modern western society and modern western medicine do, actually, have a robust notion of the child, a notion which can find its roots in three influential thinkers: Aristotle, Immanuel Kant and Jean Piaget. Together, these philosophers offer us a compelling vision: the child is primarily a future rational, autonomous adult...
June 2, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28562274/ethical-controversy-about-hysterectomy-for-a-minor
#15
Alyssa M Burgart, Julie Strickland, Dena Davis, Arlene B Baratz, Katrina Karkazis, John D Lantos
One of the most complicated ethical issues that arises in children's hospitals today is the issue of whether it is ever permissible to perform a procedure for a minor that will result in permanent sterilization. In most cases, the answer is no. The availability of good, safe, long-acting contraception allows surgical options to be postponed when the primary goal of such surgical options is to prevent pregnancy. But what if a minor has congenital urogenital anomalies or other medical conditions for which the best treatment is a hysterectomy? In those cases, the primary goal of therapy is not to prevent pregnancy...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/28555303/the-evolution-of-spina-bifida-treatment-through-a-biomedical-ethics-lens
#16
Tal Levin-Decanini, Amy Houtrow, Aviva Katz
Spina bifida is a neurodevelopmental disorder that results in a broad range of disability. Over the last few decades, there have been significant advances in diagnosis and treatment of this condition, which have raised concerns regarding how clinicians prognosticate the extent of disability, determine quality of life, and use that information to make treatment recommendations. From the selective treatment of neonates in the 1970s, to the advent of maternal-fetal surgery today, the issues that have been raised surrounding spina bifida intervention invoke principles of medical bioethics such as beneficence and nonmaleficence, while also highlighting how quality of life judgments may drive care decisions...
May 29, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28535841/the-epigenetic-effects-of-assisted-reproductive-technologies-ethical-considerations
#17
M-C Roy, C Dupras, V Ravitsky
The use of assisted reproductive technologies (ART) has increased significantly, allowing many coping with infertility to conceive. However, an emerging body of evidence suggests that ART could carry epigenetic risks for those conceived through the use of these technologies. In accordance with the Developmental Origins of Health and Disease hypothesis, ART could increase the risk of developing late-onset diseases through epigenetic mechanisms, as superovulation, fertilization methods and embryo culture could impair the embryo's epigenetic reprogramming...
May 24, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28438074/the-value-of-metaphorical-reasoning-in-bioethics-an-empirical-ethical-study
#18
Erik Olsman, Bert Veneberg, Claudia van Alfen, Dorothea Touwen
BACKGROUND: Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning. OBJECTIVE: To describe a central set of metaphors in one case and to explore their contribution to moral reasoning. METHOD: Semi-structured interviews were conducted with 16 parents of a child suffering from the neurodegenerative disease CLN3. The interviews were recorded, transcribed, and metaphors were analyzed...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28326208/a-child-as-a-donor-for-hematopoietic-stem-cell-transplantation-bioethical-justification-a-case-study-on-sickle-cell-disease
#19
Andrea Z Pereira, Ricardo Hellman, Nelson Hamerschlak, Andrea Kondo, Polianna Mara Rodrigues de Souza, Wilson Leite Pedreira, Luiz Fernando Alves Lima Mantovani, Eduardo Juan Troster, Henrique Grunspun, Marco Aurélio Scarpinella Bueno
Hematopoietic stem cell transplantation (HSCT) is an important treatment option for children with severe and refractory sickle cell disease (SCD) with debilitating clinical complications. HSCT with cells from the bone marrow of a HLA-identical sibling used in SCD has a low mortality risk, high cure rate, and high event-free survival rate after a median follow-up of 5-6 years. However, matched donors are found in only about 20% of the patients. A boy aged 8 years with SCD had a sister, <2 years old, a fully compatible donor...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28176639/personalized-medicine-in-the-paediatric-population-the-balance-between-pharmacogenetics-progress-and-bioethics
#20
Stefania Schiavone, Margherita Neri, Cristoforo Pomara, Irene Riezzo, Luigia Trabace, Emanuela Turillazzi
Personalized medicine (PM) is becoming increasingly important in contemporary clinical and research scenarios. In the context of PM, pharmacogenomics and pharmacogenetics are aimed at the genetic personalization of drug response. Extrinsic and intrinsic factors may explain inter-individual variability in drug response. Among such factors, age seems to specifically intervene to modulate drug response since normal developmental changes may influence the exposure-response relation. Consequently, the potential benefit of pharmacogenomics (PGx) in the paediatric population is considerable...
February 7, 2017: Current Pharmaceutical Biotechnology
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