Pediatric Bioethics: Allies and Advocates

Column Author: Brian S. Carter, MD | Neonatal/Perinatal Medicine, Bioethics; Interim Director, Pediatric Bioethics

Column Editor: Amita Amonker, MD, FAAP | Pediatric Hospitalist | Assistant Professor of Pediatrics, UMKC School of Medicine 

Pediatricians have long been allies both with parents and, in a developmentally appropriate manner, with children throughout the dynamic period of childhood into young adulthood. Without being an ally, pediatricians cannot truly engage with either parents or youth. The ethical importance of family-centered care requires attunement to the specific needs of a child within the context of their unique family while attending to their physical, behavioral and developmental wellbeing. And within the framework of ethically pursuing a child’s best interests, families and clinicians engage in a shared decision-making process that cannot be accomplished without allyship.

In a similar vein, pediatricians have long been advocates for children. Historically, great strides in public health, nutrition, disease and injury prevention have been made in child wellbeing. Pediatric clinicians have long given voice to those without a vote or other means to secure their future. Even today, the American Academy of Pediatrics holds formal “advocacy internships” to help pediatricians continue to speak up for children and raise their collective rights in safe, nurturing environments in which they are afforded access to education and health care.

But today, beyond the clinical paradigm of allyship and advocacy, pediatric health care professionals who are attentive to the ongoing need for consistent and equitable allyship are encouraged to use their esteemed positions, social capital and relative power to secure the wellbeing of all children. This goal may be accomplished by partnering with socially disadvantaged or marginalized individuals and communities, listening to their concerns, and working with them to achieve a real sense of inclusion. This effort may require pausing to take stock of their own opinions, biases and perspectives, paying great intention to listening to the lived experiences, daily realities and perspectives of others. One desirable objective of allyship is to mitigate the power differential that exists across groups of people – and in so doing to embark on a path toward mutual wellbeing. This connection begins at the individual and interpersonal level, where allyship notably esteems the other, in an active manner of reaching across social chasms that truly builds bridges. With allyship comes new potential.

Advocacy in the workplace attends to organizational wellbeing by addressing organizational systems and culture. It includes how everyone in a workplace gets along, accomplishes recurring and necessary tasks, develops policies and procedures to ensure that everyone’s contributions are considered, and provides a foundation of shared values. As is true for allies, advocates are other oriented and not interested in self-promotion or even in staying within their own comfort zone. Together, these allies and advocates – you and I – work toward a brighter and more inclusive future where we can secure the wellbeing of all children.