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Bioethics. 2019 Oct 2. doi: 10.1111/bioe.12670. [Epub ahead of print]

Healthcare organizations and high profile disagreements.

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Children's Mercy Bioethics Center, Children's Mercy Kansas City, Kansas City, Missouri.


In this paper, we examine healthcare organizations' responses to high profile cases of doctor-parent disagreement. We argue that, once a conflict crosses a certain threshold of public interest, the stakes of the disagreement change in important ways. They are no longer only the stakes of the child's interests or who has decision-making authority, but also the stakes of public trust in healthcare practitioners and organizations and the wide scale spread of medical misinformation. These higher stakes call for robust organization-level responses. There are responsible and thoughtful ways for healthcare organizations to directly engage with these cases. Hospitals should seek an alliance with the parents around the goal of public discussion and utilize web-based platforms to provide the public with information about medical conditions, experimental treatments, and how clinical ethics deliberation in hospitals works. We outline five important lessons for healthcare organizations to keep in mind when responding to such cases. Approached with care, these cases could become "teachable moments" for both healthcare organizations and society.


best interests; decision making; futility; media; organizational ethics; parental authority


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