Ethical issues in pediatrics

In pediatrics, as in all of health care, the depth and breadth of interest in and scholarly work on ethical issues are expanding rapidly. Ethical issues in the acquired immunodeficiency syndrome alone has become a growth industry, spawning half a dozen journals and a myriad of articles on ethical issues, including justifications for exclusion from institutional settings, involuntary testing for the benefit of others, unconsented disclosure to sexual partners, paternalistic government policies restricting access to unproven drugs, and entitlement to health care. All of these issues affect children. Nonetheless, the predominant pediatric themes in the medical ethics literature in the past year have focussed on perinatal issues: maternal-fetal conflicts, including new reproductive technologies and hazardous maternal behavior, selective nontreatment of seriously ill newborns (generally referred to as the ''Baby Doe'' issue), and an extraordinary outpouring of analyses of the uncommon issue of removing organs from anencephalic newborns.