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Prenatally-diagnosed renal failure: an ethical framework for decision-making

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Abstract

The Children’s Hospital Working Group has developed an ethical framework to guide patient care and research for prenatally diagnosed severe renal anomalies. It identifies ethical challenges in communication, timing of decisions and scarce resources. Key elements include shared decision-making, establishing a trusting relationship, and managing disagreement. The ethical framework will be used to develop a clinical pathway that operationalizes the key values of trust, honesty, transparency, beneficence, nonmaleficence, respecting parental authority, professional integrity, and justice.

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Acknowledgements

Other Members of the Ethics Consult Service at CHCO including Curtis R. Coughlin II, PhD, MBE, HEC-C; Brian M. Jackson, MD, MA, HEC-C; and Karen Jones, MS, RNC, HEC-C who reviewed and commented on drafts and the final paper.

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Authors and Affiliations

  1. Pediatrics, Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado, Aurora, CO, USA

    Jacqueline Glover

  2. Pediatrics, Nephrology, University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado, Aurora, CO, USA

    Margret Bock

  3. Pediatrics, Neonatology, University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado, Aurora, CO, USA

    Regina Reynolds

  4. OB, GYN, Maternal-Fetal Medicine, University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado, Aurora, CO, USA

    Michael Zaretsky

  5. Surgery, Pediatric Urology, University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado, Aurora, CO, USA

    Vijaya Vemulakonda

Authors
  1. Jacqueline Glover
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  2. Margret Bock
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  3. Regina Reynolds
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  4. Michael Zaretsky
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  5. Vijaya Vemulakonda
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Contributions

JG—literature review, outline development, draft preparation, final editing, submission. MB—literature review, outline development, draft review and editing. RR—literature review, outline development, draft review and editing. MZ—literature review, draft review and editing. VV—literature review, outline development, draft review and editing.

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Correspondence to Jacqueline Glover.

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Glover, J., Bock, M., Reynolds, R. et al. Prenatally-diagnosed renal failure: an ethical framework for decision-making. J Perinatol 44, 333–338 (2024). https://doi.org/10.1038/s41372-023-01779-1

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