Antiracism: An Ethical Imperative.

Pediatric ethicists hold a privileged position of influence within health care institutions. Such a position confers a corresponding responsibility to address barriers to the health and flourishing of all children. A major barrier to children's health is racism. Pediatric ethicists can, and should, leverage their position to address racism both in institutional policy and the provision of pediatric care. Health care's historical and continued contributions to fostering and sustaining racist values and systems mean that those within all medical fields- regardless of race, ethnicity, gender, age, or profession-should consider ways they can work to offset and ultimately dismantle those values and systems. Institutional policy is a critical mechanism propagating racism in hospitals and an area where ethicists have a unique perspective to bring antiracism into ethical analysis. Many institutional and organizational policies have unintended consequences, negatively impacting children and families who have been historically marginalized and oppressed. In this paper, we report and discuss existing policies, along with how they are implemented (procedures) and how they are conducted (practices), identified through a workshop during a pediatric subgroup meeting at an annual bioethics conference. We highlight the need to focus on these structural factors and reference scholarship that can be used to correct institutional policies that uphold white supremacy. We conclude with actionable, concrete recommendations for change.

Neonatal family-centered care in a pandemic.

Family-centered care (FCC) has become the normative practice in Neonatal ICUs across North America. Over the past 25 years, it has grown to impact clinician-parent collaborations broadly within children's hospitals as well as in the NICU and shaped their very culture. In the current COVID-19 pandemic, the gains made over the past decades have been challenged by "visitor" policies that have been implemented, making it difficult in many instances for more than one parent to be present and truly incorporated as members of their baby's team. Difficult access, interrupted bonding, and confusing messaging and information about what to expect for their newborn can still cause them stress. Similarly, NICU staff have experienced moral distress. In this perspective piece, we review those characteristics of FCC that have been disrupted or lost, and the many facets of rebuilding that are presently required.

Ethics Champion Programs.

A promising practice to promote moral agency in health care settings.