Autonomy or Beneficence: An Analysis of End-of-Life Care in Pediatric Patients

Autonomy and beneficence are two core principles of biomedical ethics. However, autonomy, the patient’s right to decide what he or she wants regarding medical care, can often conflict with beneficence, what the doctor believes is in the best interest of the patient. In addition, pediatric cases are more difficult, because there is a third party, the parents, involved in the decision-making process. Through literature review, this thesis analyzes how autonomy and beneficence may conflict in pediatric end-of-life care cases. Furthermore, the thesis examines how a type of autonomy, called relational autonomy, can assist in making decisions in these pediatric end-of-life care cases. In relational autonomy, parents are the driving force in the decision-making with the help of the medical staff. Parents must be strong advocates for their children. Finally, the Touchpoints program, developed by Dr. T. Berry Brazelton, is evaluated as a method of minimizing conflict between parents and physicians as parents strive to advocate for their children.