Ethical Issues in Paediatric Practice - Part II: Issues relating to disability

Ethical issues in child care are often complicated by the child's inability to take responsibility in their own management decisions and, therefore, their reliance on third parties. This situation is further complicated in those children who have an underlying disability which may influence judgement decisions of the child's surrogate guardians, both toward over or under treatment. This is particularly the case with regard to decisions relating to life support, ongoing and quality of life, appropriate use of limited healthcare resources, and medical research. This article will explore the ethical principles which help to guide the medical management of such difficult cases.