ABSTRACT
This chapter addresses three realistic situations that involve ethical choices for the pediatric surgeon. It highlights the importance of using the best-interests standard for neonatal decision making, while respecting the place of the infant within his or her parental and familial cultural milieu. The chapter discusses the ethical obligations of beneficence, autonomy, and justice that the pediatric surgeon should maintain during prenatal consultation. It then offers an ethical rationale for pediatric surgeons to participate in clinical research as a way to benefit their future infant patients. Pediatric surgeons can help insure that their ethical judgments are reliable through the application of an organized process. In addition to the difficulties associated with assessing the burdens experienced by an infant, a narrow best-interests standard cannot be applied to neonates and infants with neurological deficits so severe as to exclude the possibility of experience of any sort.
