Clinical Resources

Choose a topic:

Clinical Care

Assent/ Consent
The Best Interests Standard for Incompetent or Incapacitated Persons of All Ages.

This article discusses the issues and describes a framework for deciding if individuals can make decisions.

Rethinking pediatric assent: from requirement to ideal.

This article reviews and summarizes the difficulties with the concept and practice of assent.

Bioethics for Clinicians: 9. Involving children in medical decisions

  • Can Med Assoc (Link coming soon.)
    Harrison C, Kenny NP, Sidarous M & Rowell M.; 1997; 156:6, 825-828

This article discusses the issues related to involving children in making decisions.

Comments on Some Ethical, Legal, and Clinical Issues Affecting Consent in Treatment, Organ Transplants, and Research in Children

This article discusses issues related to organ transplantation involving children and adolescents.

Assessment
Looking with both eyes open: fact and value in psychiatric diagnosis?

  • World Psychiatry
    Fulford KWM, Broom M, Stanghellini G, and Thornton T. 2005 June; 4(2): 78-86.

The authors argue that values should be considered when making a psychiatric diagnosis.

Values in Psychiatric Diagnosis: Developments in Policy, Training and Research.

This article provides an overview of values based practice: recent developments and policy and training that are applicable to mental health.

Legal and ethical issues in child and adolescent personality assessment in Knoff HM (ed).

This chapter reviews the legal and ethical issues related to psychological assessment of children and adolescents, especially as related to personality assessment.

Collaboration with Other Professionals
Guidelines for Prescribing Psychiatrists in Consultative, Collaborative, and Supervisory Relationships.

Collaboration of Ethics and Patient Safety Programs: Opportunities to Promote Quality Care

  • HEC FORUM
    Nelson WA, Neily J, Mills J & Weeks WB; 2008; 20:1, 15-27

This article describes a collaborative effort to improve quality care.

Referrals and shared or collaborative care: managing relationships with complementary and alternative medicine practitioners

  • Pediatrics
    Gilmour J, Harrison C, Asadi L, Cohen MH, Vohra S.; 2011;128 Suppl 4:S181-6

In this article the authors discuss how practitioners should approach sharing patient care when working with providers who provide complementary and alternative care.

Treatment and Coordinated Care With Multiple Mental Health Clinicians: Clinical and Risk Management Issues

This article reviews and discuss the issues related to collaborating with other practitioners to provide patient care.

Preventing harm and promoting ethical discourse in the helping professions: conceptual, research, analytical, and action frameworks

  • Ethics Behav
    Prilleltensky I, Rossiter A, Walsh-Bowers R.; 1996;6(4):287-306

This article provides an overview of the concepts and methods developed by a team of researchers concerned with preventing harm and promoting ethical discourse in the helping professions.

Complementary, Alternative and Integrative Medicine
Ethical Issues of Complementary, Alternative, and Integrative Medicine, What do I Need to Know When Parents Ask Me about Complementary, Alternative, and Integrative Medicine?

  • AACAP Annual Meeting, 2011 (Link coming soon)
    Batzer, Institute 7, 2011

Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical, and Clinical Issues in Decision-Making.

  • Pediatrics
    Gilmour J, Harrison C, Cohen MH & Vohra S. 2011;128; S149-54.

This articles uses 8 clinical vignettes to discuss the legal, ethical and clinical issues associated with the use of complementary and alternative medicine.

Counseling families who choose complementary and alternative medicine for their child with chronic illness or disability

  • Pediatrics
    American Academy of Pediatrics Committee on Children with Disabilities; 2001;107(3):598-601

This article reviews some of the concerns and issues that occur when working with patients and families who have chosen to use complementary and alternative medicine as a part of their treatment.

Ethics of Complementary and Alternative Medicine Use in Children

This article reviews a number of the ethical issues related to the use of complementary and alternative medicine (CAM) to treat children and adolescents in the context of increasing utilization of these agents.

Culturally Competent Care
Ethical aspects in providing care to marginalized populations.

This article reviews and discusses issues related to providing mental health care to minority populations.

The cultural sensibility model: a process-oriented approach for children and adolescents.

The authors present an approach for incorporating culture within the clinical setting termed the cultural sensibility model.

ECT/Somatic Treatments
Ethics of ECT for Children

  • Journal of American Academy of Child and Adolescent Psychiatry (Link coming soon)
    Rudnick A. 2001; 40:4, 387-388
  • Ethics of Transcranial Magnetic Stimulation Research in CAP (Link coming soon)
    Jotterand, Symposium 7, 2011

Electroconvulsive Therapy in Children and Adolescents: Brief Overview and Ethical Issues

  • Matthew Sachs, MD, MPH & Vishal Madaan, MD 1.1.2012

Innovative Treatments
Compassionate and innovative treatments in children: a proposal for an ethical framework.

The article describes an ethical framework for use in clinical situations when innovative treatments are being considered.

Involuntary Hospitalization/Involuntary Treatment/Restraints
Compulsory treatment in psychiatry.

This paper reviews recent studies on the use of compulsory measures in hospital, the community and special populations.

Obligation of clinicians to treat unwilling children and young people: an ethical discussion.

This article describes an approach that seeks to balance the clinician's duty of care to their patient with the need to respect and indeed foster the developing sense of autonomy in young people.

Coercion in psychiatry

This paper highlights issues in the field of involuntary treatment in psychiatry.

A Prolegomenon on Restraint of Children: Implicating Constitutional Rights

This article reviews the use of physical restraints in youth and argues that it may be unethical and illegal.

Ethical issues in patient restraint

  • Nurs Times
    Gallagher A.; 2011 Mar 8-14;107(9):18-20

This article examines the ethical issues that arise in relation to restraint in mental health, dementia care and stroke care. The themes can, however, be applied to all areas of healthcare.

The ethics of mechanical restraints

This article reviews the clinical and ethical issues related to physical restraints of patients.

Medical Conditions
Ethics and the Care of Critically Ill Infants and Children

This paper describes The American Academy of Pediatrics (AAP) perspective on making decisions about life-sustaining medical treatment for children and adolescents.

American Academy of Pediatrics Committee on Bioethics Guidelines on Forgoing Life-Sustaining Medical Treatment.

  • Pediatrics
    American Academy of Pediatrics Committee; 1994; 93: 3, 53

American Academy of Pediatrics guidelines when making decisions about forgoing life sustaining medical treatment for children and adolescents.

Children, adolescents, and HIV

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon.)
    Etemad JG.; 1995;4:4, 823-835

This article reviews the relevant clinical and ethical issues related to working with youth with HIV/ AIDS with a focus on the issues that impact all age groups as well as those that are specific to various stages of development.

Ethical reasoning and mental health services with deaf clients

Deaf Culture, Cochlear Implants, and Elective Disability

These articles discuss the applications of relevant ethical principles when working with deaf individuals.

In one's own image: ethics and the reproduction of deafness

These articles review the various arguments and ethical concerns related to the debate about cochlear implants for hearing impaired individuals and some of the issues related to choosing to have a disability.

Physician Disclosure
Disclosing medical errors to patients: a challenge for health care professionals and institutions.

Apologizing for humiliations in medical practice.

  • Chest
    Lazare A, Levy RS. 2011 Apr;139(4):746-51.

Medication errors in psychiatry: a comprehensive review.

  • CNS Drugs
    Procyshyn RM, Barr AM, Brickell T, Honer WG. 2010 Jul;24(7):595-609.

These articles review and discuss issues related to medical errors and physician disclosure of mistakes.

Disclosure of adverse events and errors in healthcare: an ethical perspective

Institutional responses to medical mistakes: ethical and legal perspectives

Psychopathology
Beyond polemics: science and ethics of ADHD.

The author reviews current knowledge about ADHD and then discusses the clinical, social and ethical concerns related to the diagnosis and treatment of this disorder.

Facts, Values, and Attention-Deficit Hyperactivity Disorder (ADHD): An Update on the Controversies

This article summarizes the results of a series of workshops discussions by experts in various fields about issues related to the diagnosis and treatment of Attention Deficit Hyperactivity Disorder.

Controversies Concerning the Diagnosis and Treatment of Bipolar Disorder in Children

This article summarizes the results of a series of workshops discussions by experts in various fields about issues related to the diagnosis and treatment of Bipolar Disorder in children and adolescents.

Pediatric Mental Health Care Dysfunction Disorder?

The authors discuss the issues related to creating a new diagnostic category for young children with severe mood and self-regulation symptoms who often are labeled as bipolar presently. They review and discuss the issues of medication use in this group of children.

Troubled Children Diagnosing, Treating and Attending to Context

This article provides a summary of the discussion and opinions of a group of experts that developed from a series of workshops sponsored by the Hasting Center. The report describes current issues and complexities in the diagnosis and treatment of psychiatrically ill children and adolescents as well as a number of the system delivery problems.

The McDonaldization of childhood: children's mental health in neo-liberal market cultures

The author discusses how beliefs and practices around children and families, including how children and their problems are conceptualized.

Addressing complex ethical issues in the treatment of children and adolescents with eating disorders: application of a framework for ethical decision-making

This paper outlines an ethical decision-making framework that can assist the clinician in engaging the young patient and her family well in advance of a crisis, so that decisions can be made at a time when recourse to establishing incompetency or enforcing involuntary treatment are unnecessary.

Psychopharmacology
U.S./European Pediatric Drug Development Initiatives and Bioethics/New Pediatric Regulations and Cutting Edge Issues Involving Clinical Trials in CAP

  • AACAP Annual Meeting, 2011 (Link coming soon)
    Allen, Symposium 13

Applying Bioethics to Pediatric Psychopharmacology

Ethical Issues in Child and Adolescent Psychopharmacology

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon.)
    Coffey BJ.; 1995; 4:4, 793-807

This article provides an overview of the relevant clinical, research and ethical issues related to pediatric psychopharmacology.

Ethics and Pediatric Psychopharmacology

Medicolegal Issues in Prescribing Medications to Children and Adolescents

  • AACAP Annual Meeting, 2011 (Link coming soon)
    Ash, Institute 1, Advances in Treatment: Implications for Clinical Practice

Overview and discussion of some of the ethical and legal issues related to prescribing medications for children and adolescents.

Ethics and the Prescription Pad

This article reviews the ethical considerations that can influence and inform the recommendations, prescribing practices, and related behaviors of child and adolescent psychiatrists.

Psychotropic Medication Use in Vulnerable Child and Adolescent Populations: Making Appropriate Clinical and Ethical Treatment Decisions

  • AAACAP Annual Meeting, 2011 (Link coming soon.)
    Dingle (chair), Symposium 34; 2011

Overview and discussion of psychotropic medication prescribing practices in vulnerable pediatric populations with an emphasis on the relevant clinical and ethical issues that occur with youth who have state involvement and where resources are limited. The various populations discussed include: state of Washington Medicaid pediatric population, children in state custody in Illinois, youth in detention facilities in Texas and adolescents in a residential treatment facility in Connecticut.

Understanding the agreements and controversies surrounding childhood psychopharmacology

This article reviews and discusses issues related to the increased use of psychotropic medications to treat children and adolescents.

Recent findings and challenges for child and adolescent psychopharmacology

This article reviews and discusses issues related to the increased use of psychotropic medications to treat children and adolescents.

Informed Consent and Stimulant Medication: Adolescents' Understanding of Information

  • Poster 6.39, AACAP Annual Meeting 2009 (Link coming soon)
    Schachter, 2009

Informed Consent: Appreciation of Information about ADHD by Adolescents with ADHD and Their Parents

  • Poster 55, AACAP Annual Meeting 2011 (Link coming soon)
    Schachter
  • Psychopharmacology, Institute 3, Lifelong Learning Institute, AACAP Annual Meeting 2008 (Link coming soon)
    Walkup

Psychotherapy
Current Ethical Issues in Child and Adolescent Psychotherapy

This article describes some of the ethical and clinical dilemmas that commonly occur when children and adolescents are in psychotherapy.

An Ethical Perspective on Operant Conditioning.

The authors discuss some of the ethical perspectives that are relevant to psychotherapy and behavioral management.

Treatment
Clinical ethics for treatment of children and adolescents: a guide for general psychiatrists.

  • Psychiatric Clinics of North America (Link coming soon)
    Belitz J, Bailey RA. 2009;32:244-57.

This article reviews the ethical issues related to working with children and adolescents. The authors review the fundamental ways in which children are different from adults in terms of vulnerability, developmental status, reliance on the environment and options for activities.

Ethics in child and adolescent psychiatric care: an international perspective.

The authors review and discuss some of the ethical issues related to children and adolescents who are receiving psychiatric care. The CRC and several ethics codes are described and ethical concerns are described within the framework of the CRC and the UN Convention on the Rights of Persons with Disabilities (CPD).

Use of Evidence Based Treatments/Non-Evidence Based Treatments
Ethics and Evidence in Psychiatric Practice

Does evidence-based medicine apply to psychiatry?

These articles review and discuss the ethical values underlying evidence based practice in psychiatry and some of the possible conflicts with the broader ethical principles that underlie the general practice of psychiatry.

(back to top)

Patient Populations

Adolescents
Legal implications surrounding adolescent health care decision-making in matters of sex, reproduction, and gender.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Beh HG & Pietsch JH. 2004, 13: 675-694.

Overview and discussion of the ethical concerns that arise when treating adolescents, specifically when managing clinical situations that involve sexual behavior, reproductive matters and gender issues.

Adoption
The Ethics of Intercountry Adoptions: Why It Matters to Health Care Providers and Bioethicists.

The author briefly describes the history of international adoption and then discusses some of the ethical issues related to this form of adoption and other reproduction alternatives.

Transracial Adoption: The Pros and Cons and the Parents' Perspective.

The author reviews the history and data on adoption in the US and presents arguments about the benefits of transracial adoption.

Risks and Benefits of Open Adoption.

These articles provide overviews of the advantages and disadvantages of open adoption as currently practiced.

Assisted Reproductive Technology
Having Children with Help: A Review and Discussion of Current Clinical and Ethical Issues Related to Assisted Reproductive Medicine

  • Technology, Clinical Perspectives 13, AACAP Annual Meeting 2010 (Link coming soon)
    Dingle (chair)

This presentation reviews and discusses some of the issues related to having children using technology; issues are discussed from the perspectives of obstetrics, pediatrics, psychiatry and child and adolescent psychiatry.

Reproductive technology and ethics in child and adolescent psychiatry.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Harrison M. 1995;4(4):837-52.

This article reviews the processes and procedures of assisted reproductive technology (ART) with definitions and descriptions.

Families
Raising healthy children: Moral and political responsibility for childhood obesity.

The author argues that the current ethical foundations of North American public health policy, being based on the premise that parents are responsible for their children and that family functioning and structure are private not public matters, is inadequate to manage public health issues such as obesity. She recommends more attention to and adoption of the principles of the UN Convention on Children's Rights.

Child rearing in the "risk" society: on the discourse of rights and the "best interests of a child".

Smeyers contends that while the discourse of rights is clearly important and relevant insofar as the relation between parents and the state are discussed, it impoverishes our understanding of relations of family members when used as an all-inclusive framework in that context.

Infants
Fetus/Mother Clinical Report-Maternal-Fetal Intervention and Fetal Care Centers Pediatrics

The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics make recommendations regarding informed consent, the role of research subject advocates and other independent advocates, the availability of support services, the multidisciplinary nature of fetal intervention teams, the oversight of centers, and the need to accumulate maternal and fetal outcome data.

Parents
Preconception Care: A Parenting Protocol. A Moral Inquiry into the Responsibilities of Future Parents towards Their Future Children.

  • Bioethics
    Van Der Zee and De Beaufort I. 2011; 25:8, 451-457.

Using an approach developed by fertility specialists, the authors argue that parents have a moral obligation to be as healthy as possible in order to minimize harm to their children.

School Age
Power Games and Moral Territories: Ethical Dilemmas when Working with Children and Young People.

This article discusses some of the ethical issues when working with children with an emphasis on the problems related to inequality within the relationship.

Healthy children's perceptions of medicines: a review.

Literature review of healthy schoolchildren's attitudes, beliefs, and knowledge about medicines.

Toddlers/Preschoolers
Privileged treatment of toddlers: cultural aspects of individual choice and responsibility.

This article describes a study that examined different parenting approaches to toddlers which appeared to reflect cultural views of responsibility and respect for others.

"We don't play that way at preschool": The moral and ethical dimensions of controlling children's play

This article reviews views of play and some of the ethical concerns related to structuring and managing children's play behavior.

(back to top)

Settings of Care

Child Protective Services
Why are professionals failing to initiate mandated reports of child maltreatment, and are there any empirically based training programs to assist professionals in the reporting process?

This article reviews the literature on the reasons that professionals fail to report child maltreatment as well as training programs that have been developed to help professionals with this issue.

College Mental Health
Thinking About Mental Health Policy in University and College Counseling Centers

The authors discuss some of the clinical and ethical issues when college students require mental health treatment.

Should Colleges Withdraw Students Who Threaten or Attempt Suicide?

This article presents and discusses some of the issues related to working with college students with suicidal behavior.

Community Psychiatry
Ethics in contemporary community psychiatry.

  • Psychiatric Clinics of North America (Link coming soon)
    Everett A, Huffine C. 2009;32:329-41.

The authors define and describe community psychiatry. They then review the ethical concepts of beneficence, non-maleficence, autonomy, dual agency and justice.

Forensics
An Annotated Bibliography for the Testifying Child and Adolescent Psychiatrist

List of annotated references useful to support various opinions when testifying in court.

Ethics in Child and Adolescent Forensic Psychiatry

The article reviews ethics and the law, various codes of medical ethics, ethics related to child and adolescent psychiatry practice, and ethics as related to forensic psychiatry.

Inpatient
Ethical conflicts and their management in inpatient child and adolescent psychiatry.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Towbin KE, Campbell PA. 1995;4(4):747-68.

The authors discuss the importance of considering ethical issues routinely as a part of practice, especially in inpatient settings. They review some of the changes that have occurred in psychiatric care that have impacted how mental health care is practiced.

Juvenile Court/Juvenile Justice
Legal Issues, Rights, and Ethics for Mental Health in Juvenile Justice

This article reviews the ethical and legal concerns relevant to adolescents involved in the juvenile justice system. A number of legal issues are reviewed, including criminal responsibility, diminished capability, assignment to adult criminal court, competency to stand trial.

Managed Care
The History of Managed Care and the Role of the Child and Adolescent Psychiatrist

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Glasser M. 2010; 19:1, 63-74.

This article reviews some of the ethical issues arising from practicing child and adolescent psychiatry within a managed care model.

A Doubtful Guest: Managed Care and Mental Health

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Rosenberg E & DeMaso DR. 2008; 17:1, 53-66

A brief history including a description of negative physician attitudes and beliefs about managed care introduce the discussion of ethical predicaments that can occur in this clinical context.

Outpatient
Ethical challenges in mental health services to children and families.

The author provides an overview of ethical issues that occur when working with children, adolescents and families in mental health treatment with suggestions for management.

Pediatrics
Ethical issues in pediatric consultation-liaison.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Krener P. 1995;4(4):723-45.

This article reviews some of the basic history and principles of ethics relevant to child and adolescent psychiatry and then discusses some of the issues that occur when working with children and adolescents who are receiving care in pediatric settings.

Residential
Finding the Line: Boundary Decisions in Residential Treatment.

The authors examine how boundaries are viewed and addressed in residential treatment.

School
Mental health services in schools: utilization, effectiveness, and consent.

The author reviews some data on mental health services in schools and discusses some of the clinical and ethical concerns.

Physical Restraint in School

This article reviews the use of physical restraint in school and some of the ethical and safety concerns.

Ethics and Evidence in Consultation.

This article describes and discusses various clinical and ethical issues related to consultation in early childhood. Three scenarios are presented that illustrate various ethical issues related to early childhood consultation.

Systems of Care
A systems approach to ethical problems.

This article takes a systems approach to ethical problems and identifies aspects of systems that promote or impede ethical decision making. Psychological abuse of children is used as an example of a problem requiring a coordinated, systemic response to ethical issues such as autonomy, privacy, and confidentiality.

Evidence-based and Values-based Policy, Management and Practice in Child and Adolescent Mental Health Services.

This article outlines some of the key features of values-based practice including its complementary relationships to both regulatory ethics and evidence-based practice.

Telemedicine
Ethical Challenges of Telemedicine and Telehealth.

This article reviews and discusses the advantages and limitations of technology to provide health information and medical care as well as some of the relevant ethical issues.

Bridging Cultures: Child Psychiatry via Videoconferencing.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Savin D, Glueck DA, Chardavoyne J, Yager J, Novins DK. 2011; 20:1, 125-134

This article elucidates cultural challenges encountered in the practice of telepsychiatry and offers suggestions for how to deal with them.

Telepsychiatry in Juvenile Justice Settings.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Kaliebe KE, Heneghan J, Kim TJ. 2011 Jan; 20(1):113-23.

Case studies in the use of telepsychiatry to provide improved care in juvenile corrections in 4 states are described, along with a review of advantages and disadvantages of telepsychiatry in these settings.

(back to top)

General Issues

Abortion
The Adolescent's Right to Confidential Care When Considering Abortion.

  • Pediatrics
    American Academy of Pediatrics Committee on Adolescence 1996 97: 5, 747-51.

In this statement, the American Academy of Pediatrics (AAP) reaffirms its position that the rights of adolescents to confidential care when considering abortion should be protected. The AAP supports the recommendations presented in the report on mandatory parental consent to abortion by the Council on Ethical and Judicial Affairs of the American Medical Association.

Respecting adolescents' confidentiality and reproductive and sexual choices.

Adolescents may avoid parental disclosure by forgoing desirable reproductive health care. Recent judicial decisions give effect to internationally established human rights to confidentiality.

Advocacy
Advocating for Children and Adolescents with Mental Illnesses.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Ptakowski KK. 2010;19(1):131-8.

Advocacy is defined and described with examples of how child and adolescent psychiatrists can have a positive impact.

Biotechnology
Biotechnology and ethics in medical education of the new millennium: physician roles and responsibilities.

The authors discuss some of potential ramifications of the increasing availability of new, innovative and costly health care interventions due to improvements in technology.

When choosing the traits of children is hurtful to others.

This article reviews some of the issues related to using technology to avoid having children with disabilities.

Choosing disabilities and enhancements in children: a choice too far?

This article reviews some of the issues related to using technology to have children with or without certain characteristics.

Boundaries
Boundaries in child and adolescent psychiatry.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Schetky D. 1995;4(4):769-78.

This article discusses the fiduciary relationship between physicians and patients and the accompanying constraints and expectations that govern physician behavior in this context.

Enhancement
Authenticity and Ambivalence: Toward Understanding the Enhancement Debate

On Good and Bad Forms for Medicalization.

  • Bioethics
    Parens E. 2011. doi: 10.1111/j.1467-8519.2011.01885.x

These articles review some of the issues related to using various technologies, particularly pharmacology for self-improvement and then discusses the importance of considering the differences between good and bad forms of medicalization.

Pharmacological Cognitive Enhancers in Children and Adolescents

  • David R. Meyer, D.O. and Vishal Madaan, M.D. 1.1.2012

Conflict of Interest
Update on Ethics in CAP: Guidelines for Managing Conflicts of Interest

  • Institute 3, Lifelong Learning Institute, AACAP Annual Meeting 2009 (Link coming soon)
    Greenhill

Conflicts of Interest Between Physicians and the Pharmaceutical Industry and Special Interest Groups

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Schetky DH. 2008; 17:1, 113-125.

This article describes and discusses a number of the issues related to physician relationships with pharmaceutical organizations and special interest groups.

Cultural and Ethnic Issues
Clinical Case 1, Voices, Demons, and Complex Cases: A Multi-Perspective Approach

  • AACAP Annual Meeting 2010 (Link coming soon)
    Dell (chair)

This presentation reviews and discusses various aspects of care such as cultural, spiritual, family and ethical issues using a clinical case to provide context.

Research ethics for mental health science involving ethnic minority children and youths.

  • American Psychologist
    Fisher, Celia B.;Hoagwood, Kimberly;Boyce, Cheryl;Duster, Troy;Frank, Deborah A.;Grisso, Thomas;Levine, Robert J.;Macklin, Ruth;Spencer, Margaret Beale;Takanishi, Ruby;Trimble, Joseph E.;Zayas, Luis H. 2002; 57(12), 1024-1040.

This report summarizes the key recommendations distilled from discussions of a national group of experts.

Developmental Considerations
Ethics in Child Development and Beyond School

  • Symposium 18, AACAP Annual Meeting 2010 (Link coming soon)
    Stone, Development. Stone, Joseph's Noshpitz's Journey of Child Development.

Gender Issues
Gender, Sex, and Professional Ethics in Child and Adolescent Psychiatry

Overview and discussion of clinical and ethical issues that arise when child and adolescent psychiatrists are involved in the assessment and treatment of youth with sex or gender issues.

Ethical and legal aspects of management for disorders of sex development.

This article provides a brief review of some of ethical issues related to the care of children with intersex disorders and describes ethical and legal approaches that have been implemented in Australia.

Genetics
Ethical and Legal Issues in Genetic Testing of Children, The Emerging Role of Molecular Diagnoses in Child Psychiatry.

  • Symposium 25, AACAP Annual Meeting 2010 (Link coming soon)
    Applebaum

Bioethical Issues in Neuropsychiatric Genetic Disorders

This article reviews and discusses relevant clinical and ethical issues related to clinical practice and research with individuals with neuropsychiatric genetic disorders.

Genetics of Childhood Disorders: XLI. Stem Cell Research, Part 5: Ethical Questions

The authors review and discuss ethical and moral dilemmas related to research with stem cells.

Health Care Disparities
Children's health inequalities Ethical and political challenges to seeking social justice.

This review discusses the health inequalities related to disease and care that disadvantaged children suffer from.

Racial and ethnic disparities in pediatric mental health.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Alegria M, Vallas M & Pumariega AJ. 2010 Oct;19(4):759-74.

This article offers a comprehensive picture of the status of pediatric disparities, by addressing the major areas affecting minority youth mental health.

Internet and Media
New Media and an Ethics Analysis Model for Child and Adolescent Psychiatry.

Relevant ethical concepts, particularly those related to the effect of media on children and adolescents and the responsibilities of child and adolescent psychiatrists and other involved adults are reviewed.

Issues of Conscience
Physician refusal to provide information or treatment on the basis of claims of conscience.

This American Academy of Pediatrics (AAP) policy statement discusses the importance of respecting physician's moral stances but that patients' access to care should not be impeded.

Policy statement - pediatrician-family-patient relationships: managing the boundaries.

This AAP policy statement reviews the issues related to physicians providing care for their own family members and maintaining appropriate boundaries with patients and patient families.

Legal Issues
Forensic Aspects of Everyday Practice: Legal Issues That Every Practitioner Must Know

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Vernick AE. 2002; 11:4, 905-928.

This article reviews and discusses forensic, legal and ethical issues that child and adolescent psychiatrists should know for clinical practice.

Parental Rights
Termination of Parental Rights - Ethical Issues and Role Conflicts

Managing ethically questionable parental requests: Growth suppression and manipulation of puberty.

This article briefly reviews some of the ethical and clinical concerns when parents request medical interventions that are not medically necessary with a focus on therapies to prevent or delay puberty.

Professionalism
Professionalism: the formation of physicians.

The author reviews and discusses concepts of professionalism within the context of educating physicians to be competent practitioners.

Religious Issues
Ethical Issues in Addressing Religion and Spirituality in Clinical Care, Religion and Spirituality in CAP

  • Institute 2, AACAP Annual Meeting 2010 (Link coming soon)
    Dell 2010

Identifying and integrating helpful and harmful religious beliefs into psychotherapy.

Types of religious beliefs that contribute to distress, particularly for youth, are identified and treatment options are offered.

Child welfare versus parental autonomy: medical ethics, the law, and faith-based healing.

This paper provides a framework for understanding and working with parental religious beliefs which may impact the welfare of their children.

Socioeconomic Issues
CAP in the Trenches: Clinical and Ethical Dilemmas When Treating Poor Children and Families

  • Clinical Case 3, AACAP Annual Meeting 2010 (Link coming soon)
    Dingle & Jacob (chairs)

Health inequities and social justice. The moral foundations of public health.

This article addresses why considerations of justice are most foundational to public health.

Cultural, gender, and socioeconomic contexts in therapeutic and social policy work.

"Just therapy" with families on low incomes.

These articles discuss the issues related to poor families having socioeconomic, cultural and gender difficulties, which are directly related to their mental health problems and that practitioners have an obligation to identify, address and advocate about these issues.

Sexuality Issues
Legal Implications Surrounding Adolescent Health Care Decision-Making in Matters of Sex, Reproduction, and Gender.

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Beh HG & Pietsch JH. 2004; 13:3, 675-694.

The ethics of abstinence-only and abstinence-plus sexuality education.

This article reviews some of the ethical issues related to sex education.

Technology
Young children as regenerative tissue donors: considering the need for legal reform in light of divergent ethical approaches.

This article examines the ethical approaches that have featured in the debate over the acceptability and limits of the practice of having young children donate bodily tissues to treat another individual.

Eliciting ethical and social values in health technology assessment: A participatory approach.

  • Soc Sci Med.
    Bombard Y, Abelson J, Simeonov D, Gauvin FP. 2011;73(1):135-44.

Despite a growing consensus that ethical and social values should be addressed in health technology assessment (HTA) processes, there exist a variety of methods for doing so. There is growing interest in involving citizens in policy development to ensure that decisions are legitimate, and reflect the broad social values of the public. A 14-person Citizens' Reference Panel on Health Technologies was established to provide input to the Ontario Health Technology Advisory Committee in developing its recommendations. Over the course of five meetings, panel members progressed toward the identification of a set of core values -universal access, choice and quality care.

Mind the child: using interactive technology to improve child involvement in decision making about life-limiting illness.

In this article the authors comment on the bioethical works of B. Levi and M. Green concerning their computer-based system that assists individuals in making end-of-life decisions. They discuss how interactive technology may increase the involvement of terminally ill children in making decisions about palliative care.

(back to top)

Environmental Factors

Abuse/ Neglect
Reporting Child Abuse: The Ethical Obligation to Inform Parents.

  • Journal of American Academy of Child and Adolescent Psychiatry (Link coming soon)
    Racusin RJ, Felsman JK. 1986, 25:4, 485-489.

This article discusses the ethical obligations of physicians to discuss reports to child protective services with the patient and family. The authors argue that it is in the best interests of the child to talk to the parents since it increases the likilhood that the parents will get help and that the therapeutic alliance will be perserved. Also, non disclosure may leave the child at risk for a longer period of time. The authors discuss potential challenges in talking with parents and possible approaches.

An ethical approach to resolving value conflicts in child protection.

Child protection professionals working in diverse societies are regularly faced with value conflicts. Recognizing these, and resolving them in the best interests of children, is a task that requires child protection specialists to make complex judgments and decisions. In this paper the philosophical concepts of absolutism and relativism to child abuse are applied, and it explores how this approach has practical relevance to solving ethical dilemmas in child protection.

Disasters
Ethical Issues in Local, National, and International Disaster Psychiatry

  • Child and Adolescent Psychiatric Clinics of North America (Link coming soon)
    Joshi PT, Dalton ME, O'Donnell. 2008; 17:1, 165-185.

This article discusses some of the ethical conflicts that can occur when providing psychiatric care to children, adolescents and families who are suffered from a disaster. The basic rights of youth to education, life and protection are reviewed. Understanding and managing ethical concerns such as confidentiality, autonomy, informed consent and balancing patient and society rights in various cultural and social environments are discussed. Approaches to comprehending illness and trauma within a cultural framework to provide clinical care and conduct research are detailed. The importance and impact of professionalism, value systems and views of children's rights are explained.

(back to top)