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Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda

Technological advancements and rapid expansion in the clinical use of extracorporeal life support (ECLS) across all age ranges in the last decade, including during the COVID-19 pandemic, has led to important ethical considerations. As a costly and resource intensive therapy, ECLS is used emergently...

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Autores principales: Clark, Jonna D., Baden, Harris P., Berkman, Emily R., Bourget, Erica, Brogan, Thomas V., Di Gennaro, Jane L., Doorenbos, Ardith Z., McMullan, D. Michael, Roberts, Joan S., Turnbull, Jessica M., Wilfond, Benjamin S., Lewis-Newby, Mithya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160718/
https://www.ncbi.nlm.nih.gov/pubmed/35664885
http://dx.doi.org/10.3389/fped.2022.896232
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author Clark, Jonna D.
Baden, Harris P.
Berkman, Emily R.
Bourget, Erica
Brogan, Thomas V.
Di Gennaro, Jane L.
Doorenbos, Ardith Z.
McMullan, D. Michael
Roberts, Joan S.
Turnbull, Jessica M.
Wilfond, Benjamin S.
Lewis-Newby, Mithya
author_facet Clark, Jonna D.
Baden, Harris P.
Berkman, Emily R.
Bourget, Erica
Brogan, Thomas V.
Di Gennaro, Jane L.
Doorenbos, Ardith Z.
McMullan, D. Michael
Roberts, Joan S.
Turnbull, Jessica M.
Wilfond, Benjamin S.
Lewis-Newby, Mithya
author_sort Clark, Jonna D.
collection PubMed
description Technological advancements and rapid expansion in the clinical use of extracorporeal life support (ECLS) across all age ranges in the last decade, including during the COVID-19 pandemic, has led to important ethical considerations. As a costly and resource intensive therapy, ECLS is used emergently under high stakes circumstances where there is often prognostic uncertainty and risk for serious complications. To develop a research agenda to further characterize and address these ethical dilemmas, a working group of specialists in ECLS, critical care, cardiothoracic surgery, palliative care, and bioethics convened at a single pediatric academic institution over the course of 18 months. Using an iterative consensus process, research questions were selected based on: (1) frequency, (2) uniqueness to ECLS, (3) urgency, (4) feasibility to study, and (5) potential to improve patient care. Questions were categorized into broad domains of societal decision-making, bedside decision-making, patient and family communication, medical team dynamics, and research design and implementation. A deeper exploration of these ethical dilemmas through formalized research and deliberation may improve equitable access and quality of ECLS-related medical care.
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spelling pubmed-91607182022-06-03 Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda Clark, Jonna D. Baden, Harris P. Berkman, Emily R. Bourget, Erica Brogan, Thomas V. Di Gennaro, Jane L. Doorenbos, Ardith Z. McMullan, D. Michael Roberts, Joan S. Turnbull, Jessica M. Wilfond, Benjamin S. Lewis-Newby, Mithya Front Pediatr Pediatrics Technological advancements and rapid expansion in the clinical use of extracorporeal life support (ECLS) across all age ranges in the last decade, including during the COVID-19 pandemic, has led to important ethical considerations. As a costly and resource intensive therapy, ECLS is used emergently under high stakes circumstances where there is often prognostic uncertainty and risk for serious complications. To develop a research agenda to further characterize and address these ethical dilemmas, a working group of specialists in ECLS, critical care, cardiothoracic surgery, palliative care, and bioethics convened at a single pediatric academic institution over the course of 18 months. Using an iterative consensus process, research questions were selected based on: (1) frequency, (2) uniqueness to ECLS, (3) urgency, (4) feasibility to study, and (5) potential to improve patient care. Questions were categorized into broad domains of societal decision-making, bedside decision-making, patient and family communication, medical team dynamics, and research design and implementation. A deeper exploration of these ethical dilemmas through formalized research and deliberation may improve equitable access and quality of ECLS-related medical care. Frontiers Media S.A. 2022-05-19 /pmc/articles/PMC9160718/ /pubmed/35664885 http://dx.doi.org/10.3389/fped.2022.896232 Text en Copyright © 2022 Clark, Baden, Berkman, Bourget, Brogan, Di Gennaro, Doorenbos, McMullan, Roberts, Turnbull, Wilfond, Lewis-Newby and Seattle Ethics in ECLS (SEE) Consortium. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Clark, Jonna D.
Baden, Harris P.
Berkman, Emily R.
Bourget, Erica
Brogan, Thomas V.
Di Gennaro, Jane L.
Doorenbos, Ardith Z.
McMullan, D. Michael
Roberts, Joan S.
Turnbull, Jessica M.
Wilfond, Benjamin S.
Lewis-Newby, Mithya
Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
title Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
title_full Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
title_fullStr Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
title_full_unstemmed Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
title_short Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda
title_sort ethical considerations in ever-expanding utilization of ecls: a research agenda
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160718/
https://www.ncbi.nlm.nih.gov/pubmed/35664885
http://dx.doi.org/10.3389/fped.2022.896232
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