Family Centered Bioethics: A New Bioethical Framework for Decision-Making in Neonatal and Pediatric Units

Gonzalez-Melado FJ, Teleman AA and Di Pletro ML

Pediatric bioethics emerged from the transfer of the framework of bioethical reflection on adult competent patients, which focuses on the principle of autonomy, to minors and incompetent patients. However, we believe that the framework of patient autonomy is not appropriate for pediatric bioethics and propose a new framework based on the moral responsibility of parents and health care professionals towards the needs of the sick child. The essential elements in creating a new framework for pediatric bioethics are: the primacy of the principle of beneficence, over the principle of autonomy; the therapeutic alliance as an effective and genuine union between the physician, child patient and parents; the therapeutic intentionality as the engine of this alliance; and finally, a real family-centered care. These elements establish the bioethical framework of neonatal and pediatric units, by integrating the child’s interests within the family’s, and permits us to propose an authentically family-centered bioethics.