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...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.896232/full |
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| author | Jonna D. Clark Jonna D. Clark Jonna D. Clark Harris P. Baden Emily R. Berkman Emily R. Berkman Emily R. Berkman Erica Bourget Thomas V. Brogan Jane L. Di Gennaro Ardith Z. Doorenbos Ardith Z. Doorenbos D. Michael McMullan Joan S. Roberts Jessica M. Turnbull Jessica M. Turnbull Benjamin S. Wilfond Benjamin S. Wilfond Mithya Lewis-Newby Mithya Lewis-Newby Mithya Lewis-Newby Seattle Ethics in ECLS (SEE) Consortium |
| author_facet | Jonna D. Clark Jonna D. Clark Jonna D. Clark Harris P. Baden Emily R. Berkman Emily R. Berkman Emily R. Berkman Erica Bourget Thomas V. Brogan Jane L. Di Gennaro Ardith Z. Doorenbos Ardith Z. Doorenbos D. Michael McMullan Joan S. Roberts Jessica M. Turnbull Jessica M. Turnbull Benjamin S. Wilfond Benjamin S. Wilfond Mithya Lewis-Newby Mithya Lewis-Newby Mithya Lewis-Newby Seattle Ethics in ECLS (SEE) Consortium |
| author_sort | Jonna D. Clark |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-12T04:52:55Z |
| format | Article |
| id | doaj.art-252b0a9d02434625af68f778ccef9d9f |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-12T04:52:55Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-252b0a9d02434625af68f778ccef9d9f2022-12-22T00:37:25ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-05-011010.3389/fped.2022.896232896232Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research AgendaJonna D. Clark0Jonna D. Clark1Jonna D. Clark2Harris P. Baden3Emily R. Berkman4Emily R. Berkman5Emily R. Berkman6Erica Bourget7Thomas V. Brogan8Jane L. Di Gennaro9Ardith Z. Doorenbos10Ardith Z. Doorenbos11D. Michael McMullan12Joan S. Roberts13Jessica M. Turnbull14Jessica M. Turnbull15Benjamin S. Wilfond16Benjamin S. Wilfond17Mithya Lewis-Newby18Mithya Lewis-Newby19Mithya Lewis-Newby20Seattle Ethics in ECLS (SEE) ConsortiumDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesTreuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesTreuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, United StatesFred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDepartment of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, United StatesDepartment of Biobehavioral Nursing Science, College of Nursing, University of Illinois, Chicago, IL, United StatesDivision of Pediatric Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United StatesCenter for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of Pediatric Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesTreuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, United StatesDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesDivision of Pediatric Bioethics and Palliative Care, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United StatesTreuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, United StatesTechnological 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.https://www.frontiersin.org/articles/10.3389/fped.2022.896232/fullcritical careethicsextracorporeal life support (ECLS)extracorporeal membrane oxygenation (ECMO)researchcommunication |
| spellingShingle | Jonna D. Clark Jonna D. Clark Jonna D. Clark Harris P. Baden Emily R. Berkman Emily R. Berkman Emily R. Berkman Erica Bourget Thomas V. Brogan Jane L. Di Gennaro Ardith Z. Doorenbos Ardith Z. Doorenbos D. Michael McMullan Joan S. Roberts Jessica M. Turnbull Jessica M. Turnbull Benjamin S. Wilfond Benjamin S. Wilfond Mithya Lewis-Newby Mithya Lewis-Newby Mithya Lewis-Newby Seattle Ethics in ECLS (SEE) Consortium Ethical Considerations in Ever-Expanding Utilization of ECLS: A Research Agenda Frontiers in Pediatrics critical care ethics extracorporeal life support (ECLS) extracorporeal membrane oxygenation (ECMO) research communication |
| 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 | critical care ethics extracorporeal life support (ECLS) extracorporeal membrane oxygenation (ECMO) research communication |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.896232/full |
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