Bariatric surgery for obese children and adolescents: a review of the moral challenges [Book Review]
BMC Medical Ethics 14 (1):18 (2013)
Abstract |
BackgroundBariatric surgery for children and adolescents is becoming widespread. However, the evidence is still scarce and of poor quality, and many of the patients are too young to consent. This poses a series of moral challenges, which have to be addressed both when considering bariatric surgery introduced as a health care service and when deciding for treatment for young individuals. A question based (Socratic) approach is applied to reveal underlying moral issues that can be relevant to an open and transparent decision making process.DiscussionA wide range of moral issues with bariatric surgery for children and adolescents is identified in the literature. There is a moral imperative to help obese minors avoiding serious health problems, but there is little high quality evidence on safety, outcomes, and cost-effectiveness for bariatric surgery in this group. Lack of maturity and family relations poses a series of challenges with autonomy, informed consent, assent, and assessing the best interest of children and adolescents. Social aspects of obesity, such as medicalization, prejudice, and discrimination, raise problems with justice and trust in health professionals. Conceptual issues, such as definition of obesity and treatment end-points, present moral problems. Hidden interests of patients, parents, professionals, industry, and society need to be revealed.SummaryPerforming bariatric surgery for obese children and adolescents in order to discipline their behavior warrants reflection and caution. More evidence on outcomes is needed to be able to balance benefits and risks, to provide information for a valid consent or assent, and to advise minors and parents
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Keywords | Bariatric surgery Children Adolescents Ethics Moral |
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DOI | 10.1186/1472-6939-14-18 |
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References found in this work BETA
Why Moral Philosophers Are Not and Should Not Be Moral Experts.David Archard - 2011 - Bioethics 25 (3):119-127.
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Participation in Biomedical Research: The Consent Process as Viewed by Children, Adolescents, Young Adults, and Physicians.John C. Fletcher - forthcoming - Research Ethics.
Stuck in the Middle: The Many Moral Challenges With Bariatric Surgery.Bjørn Hofmann - 2010 - American Journal of Bioethics 10 (12):3-11.
Debating Ethical Expertise.Norbert L. Steinkamp, Bert Gordijn & Henk A. . M. . J. Ten Have - 2008 - Kennedy Institute of Ethics Journal 18 (2):173-192.
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Citations of this work BETA
Ethical Considerations in the Treatment of Childhood Obesity.Mandy Perryman & Kara Sidoti - forthcoming - Medicolegal and Bioethics:17.
Closing the Barn Door: Coping with Findings of Research Misconduct by Trainees in the Biomedical Sciences.Barbara K. Redman & Arthur L. Caplan - 2015 - Research Ethics 11 (3):124-132.
Three Scenarios Illustrating Ethical Concerns When Considering Bariatric Surgery in Obese Adolescents with Prader-Willi Syndrome.Maria Luisa Di Pietro & Drieda Zaçe - 2020 - Journal of Medical Ethics 46 (11):738-742.
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