What do you see when you look at me?: Confronting bias, power, and oppression in pediatric ethics

Abstract: The clinical practice of medicine uncovers social inequities, problems with accessing timely and appropriate care, and encountering social and clinical hierarchies that impact power differences across and within the subcultures of society and the healing arts. We formed an interdisciplinary panel, from four geographic regions in the United States, comprised of two social workers, an academic physician-ethicist, and a pediatric clinical ethicist to examine power and bias in a way that fosters transparency while building honest, authentic relationships.

Through the combination of narrative exploration and the presentation of a novel pediatric clinical ethics tool, attendees will have the opportunity to unpack, confront, and grow their practice of clinical ethics consultation. Drawing on a powerful narrative of difference and relationship we will reflect on how we walk alongside children and their families as they negotiate a complex care environment, and we attend to their most basic human needs. Then the panel will introduce a newly created tool for pediatric ethics consultation that can be used to confront bias, power, and oppression in shared decision making with patients and families regardless of age. The tool takes a novel behavioral-based approach to ethics consultation. It incorporates intentional and iterative pauses for reflection and exploration of bias, oppression, or power differentials impacting case analysis and recommendations. This process helps to clarify the assessment and analysis of ethical challenges. The discussion will conclude with an exploration of the value of including topics of bias, diversity, and oppression in clinical ethics consultation.

Keywords: Social Justice, Pediatric Ethics, Ethics Consultation