Pediatric Medicine

This history of the evolution of pediatrics from the beginning of recorded civilization examines chronologically the medical and societal antecedents of current child care. Although the term "pediatrics" is modern, the book explores the antecedents that facilitated the evolution of pediatric care as a separate discipline and a unique science. These antecedents include ancient manuscripts and the writings of acknowledged medical classicists, and the works of physicians in the East who recorded the medicine of the ancients, their own original theories, clinical observations, and experience, and exported their wisdom to the West.

ISSUES IN BIOMEDICAL ETHICS General Editors: John Harris, University of Manchester; S(ren Holm, University of Copenhagen. Consulting Editor: Ranaan Gillon, Director, Imperial College Health Service, London. North American Consulting Editor: Bonnie Steinbock, Professor of Philosophy, SUNY, Albany. The late twentieth century has witnessed dramatic technological developments in biomedical science and the delivery of health care, and these developments have brought with them important social changes. All too often ethical analysis has lagged behind these changes. The purpose of this series is to provide lively, up-to-date, and authoritative studies for the increasingly large and diverse readership concerned with issues in biomedical ethics--not just health care trainees and professionals, but also social scientists, philosophers, lawyers, social workers, and legislators. The series will feature both single-author and multi-author books, short and accessible enough to be widely read, each of them focused on an issue of outstanding current importance and interest. Philosophers, doctors, and lawyers from several countries already feature among the contributors to the series. It promises to become the leading channel for the best original work in this burgeoning field. this book: Lainie Friedman Ross presents an original and controversial examination of the moral principles that guide parents in making health care decisions for their children, and the role of children in the decision-making process. She opposes the current movement to increase child autonomy, in favour of respect for family autonomy. She argues that children should be included in the decision-making process but that parents should be responsible for their children's health care even after the children have achieved some threshold level of competency. The first half of the book presents and defends a model of decision-making for children's health care; the second half shows how it works in various practical contexts, considering children as research subjects and as patients, organ donorship, and issues relating to adolescent sexuality. Implementation of Ross's model would result in significant changes in what informed consent allows and requires for paediatric health care decisions. This is the first systematic medical ethics book that focuses specifically on children's health care. It has important things to say to health care providers who work with children, as well as to ethicists and public policy analysts.

Written by a pediatrician for pediatric clinicians on the front line in response to the ever increasing obligations they acquire for the well being of children, this book focuses on the potential of health care to impact the social morbidities that affect children's health. Dr. Rushton does not suggest that child health practitioners must do more, but rather they must reorient their efforts in order to achieve optimal outcomes for children. As specialists in child health, pediatric clinicians have skills they can utilize to ensure better outcomes for children, but doing so will require a reorganization of health supervision and the establishment of links with other social services.

Families of children with special health needs frequently cite difficulties in their communications with physicians and other medical professionals. Indeed, parents of high-risk, chronically ill, and disabled infants often regard interactions with health care providers as one of the most stressful parts of their early experiences with their children. This volume was designed to present a variety of medical education approaches used to overcome this problem. The models and viewpoints represented include those of physicians, early intervention professionals, professionals with backgrounds in education, psychology, and sociology, and parents.

Cancer is a very rare disease in children. There have been impressive gains in survival in recent years, and these have been achieved through the use of chemotherapy and national and international clinical trials. The diagnosis of cancer in a child imposes considerable stress on the whole family. In the immediate time after diagnosis, parents must learn about the disease and its treatment, explain what is happening to the child, and make arrangements for the care of other children in the family. For the child, treatment is associated with many side effects depending on the specific drugs used. In addition, the child is prone to infection and therefore is likely to miss a lot of school and other activities. For all these reasons, physicians and families have become aware that cancer has huge implications for the quality of the child's life. This book is an attempt to describe how quality of life is affected at different stages of the disease process. Comprehensive reviews are provided of the impact on the child's physical activity, social life, and school and educational achievements. Special consideration is given to children with leukemia (one of the more common cancers) and brain tumors. Cancer does not just affect the child but every member of the family. Consequently there is coverage of the effects on parents and also healthy brothers and sisters. To the extent that improvements in survival have been achieved by national and international collaboration between clinicians, it is concluded that efforts to improve the quality of these children's lives is dependent on collaboration between clinicians, nurses, and behavioral scientists at national and international levels. This book should provide an impetus for such collaboration.