The Treuman Katz Center for Pediatric Bioethics at Seattle Children's Hospital hosted its sixth annual international pediatric bioethics conference, "Tiny Babies, Large Questions: Ethical Issues in Prenatal and Neonatal Care," on July 23 and 24, 2010, in Seattle. The conference featured nationally recognized speakers in bioethics and drew more than 250 participants from across the nation and around the world.

2010 Bioethics Conference Introduction

Tiny Babies, Large Questions: Ethical Issues in Prenatal and Neonatal Care

Presented by the Treuman Katz Center for Pediatric Bioethics

For most families, pregnancy and the birth of a child represent an exciting and joyous time of hope and celebration. But sometimes, difficult and challenging ethical issues can emerge regarding the application of medical technology, the role of parental decision-making and the impact of these decisions on tiny and vulnerable human beings.

Ethical questions surrounding prenatal and neonatal care include:

  • Should there be limits on the use of reproductive technologies that may adversely affect the health of the child?
  • How should healthcare providers decide when to offer promising but untested invasive fetal interventions?
  • When an infant is born very prematurely, should parents be allowed to forgo life-saving treatment that a healthcare provider thinks could save the infant's life?
  • Under what circumstances should a healthcare provider be allowed to refuse to resuscitate an infant over the parents' wishes?
  • Does society have an obligation to support parents of children who have been born prematurely or with significant disabilities?
  • When financial resources are limited, how do we justify using more expensive technologies to help a few infants now, when doing so may be at the expense of many infants in the future?

Leaders in the field of pediatric bioethics discussed these and other issues on July 23 and 24, 2010, in the picturesque city of Seattle.

2010 Pediatric Bioethics Conference Presentations

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Day 1

Morning Session: Issues Related to Care of the Neonate

Welcome and Introduction

Benjamin Wilfond, MD
Moderator: Holly Tabor, PhD 

Neonatal Resuscitation: What Makes the Gray Zone Gray?

Presented by John Lantos, MD
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Whose Best Interest? Resuscitation Decisions for Neonates

Presented by Annie Janvier, MD, PhD
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When the Beginning Is the End: Ethical and Practical Issues in Neonatal End-of-Life Care

Presented by Marcia Levetown, MD
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Panel and Questions: Norman Fost, John Lantos, Marcia Levetown, Annie Janvier, David Loren, Mark Mercurio  
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Afternoon Session: Issues That Arise Prior to Birth

Welcome and Introduction
Moderator: Douglas Opel, MD, MPH 

Maternal Autonomy and Maternal Responsibility: Possible Conflicts of Rights and Obligations in Pregnancy

Presented by Mark Mercurio, MD, MA
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Making Trouble Making Babies: What Limits on IVF?

Presented by Jeff Ecker, MD
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Maternal-Fetal Surgery: The Clinical Promise and the Ethical Pitfalls

Presented by Elena Gates, MD
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Panel and Questions: Jeff Ecker, Norman Fost, Elena Gates, Annie Janvier, Mark Mercurio, David Woodrum  
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Parental Perspectives About the NICU: When the Doc Is the Parent

Presented by Annie Janvier, MD, PhD, and James Barrington, MB ChB
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Concluding Comments and Adjourn

Day 2

Welcome and Introduction

Douglas Diekema, MD, MPH
Moderator: Craig Rubens, MD, PhD

Better Early Than Never? Ethical Dilemmas in Preterm Birth and Survival in Resource-Poor Settings

Presented by Maneesh Batra, MD, and Maureen Kelley, PhD
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The Unequal Burden of Global Neonatal Mortality: What Values Should Be Prioritized?

Presented by Sadath Sayeed, MD, JD
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Medical Missions to Developing Countries: Whose Needs Are Being Met?

Presented by Ryan McAdams, MD
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Panel and Questions: Maneesh Batra, Maureen Kelley, Ryan McAdams, Sadath Sayeed  
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Presentations of Submitted Papers

Moderator: Douglas Diekema, MD, MPH 

  • Doctor, What Do You Think We Should Do?  Renee Boss, MD
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  • The Specter of Disability and Its Impact on Hope in Prenatal Counseling Teresa Savage, PhD
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  • Avoiding Baby Doe Redux: Dismantling the Born-Alive Infants Protection Act Myth  Jonathan Fanaroff, MD
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  • The Biopsychosocial Effects of Long-Term Care on the Families of NICU Patients  Frank Placencia, MD
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  • The Care of Newborns in Trisomy 13 and 18: Professional Practice Styles, A National Survey of Training Centers  Yoram Unguru, MD
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  • Shedding Light on the Gray Zone: How Much Discretion Should Parents Have in Decisions About Life-Sustaining Treatment for Newborn Infants in Birth Asphyxia? Dominic Wilkinson, DPhil
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Concluding Comments and Adjourn

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