Ethical Challenges of Caring for Children and Adolescents from the Perspective of Pediatricians

 Today, pediatricians face many ethical challenges and dilemmas in clinical practice. The present study has been conducted with the aim of explaining these challenges in the domain of pediatric and adolescent care from the perspective of pediatricians.

 This study has been conducted through qualitative approach and content analysis method in 2022. The samples were selected using purposive sampling method and included 20 pediatricians working at Children's Medical Center Hospital, affiliated to Tehran University of Medical Sciences. The data were collected through in-depth and semi-structured individual interviews and analyzed using the conventional content analysis approach.

Ethical Considerations: 

In this study, consent was obtained from the participants before conducting the interviews and none of their names have been published. Besides, the study has been conducted under the code of ethics (IR.TUMS.CHMC.REC.1399.165).

 Through analyzing the interviews, three categories of challenges were extracted: "The challenges faced by both children and adolescents", "The challenges exclusively faced by adolescents" and "The challenges existing in the pediatric intensive care unit". The challenges faced by both children and adolescents include three sub-categories: "The factors related to the healthcare staff"," The factors related to parents" and "organizational and policy making issues". The challenges exclusively faced by adolescents include two sub-categories: "The society-related problems" and "The problems related to the healthcare environment". The challenges existing in the pediatric intensive care unit include three sub-categories: "The mental and psychological effects of hospitalization in intensive care units on children, adolescents and parents", "The lack of resources and structural facilities" and "The problems related to dying and recently lost children".

 The results of this study indicate that many of the ethical challenges in pediatric medicine either stem from the healthcare staff or parents’ unfamiliarity with ethical and legal issues, or are the result of structural problems in the healthcare system such as the lack of executive policies and procedures or the shortage of resources and equipment. Therefore, paying attention to teaching these issues and explaining these policies and procedures, in line with the implementation of the law on the protection of children and adolescents and providing the necessary resources, is the main need and challenge that must be addressed.