USA Surgery Today

The purpose of this section is to review aspects that require emphasis for the treatment of children with physical disabilities.

The principles on which decision making are based for children with disabilities are the same as for typical children: autonomy, beneficence, justice, nonmaleficence, veracity, and fidelity (1). Parents and legal guardians are recognized legally as substitute decision makers for neurologically impaired children.

It is important for pediatricians and pediatric surgeons to discuss openly and forthrightly their approaches toward the treatment of severely cognitively impaired children. Agreement on principles is essential to provide best care. When conflicts arise, helpful mediation by a single member of a hospital’s Ethics Committee can be useful, without being cumbersome and time consuming. If true conflicts exist over specific cases, then formal consideration by the hospital Ethics Committee can help with resolution (2), although this is rarely required.