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viagra for dogs with chf levitra para que sirve compare and contrast essay examples college level C. Parental consent versus parental permission. The 1995 aap committee on bioethics policy statement "informed consent, parental permission, and assent in pediatric practice" embraced the concept of parental permission. Parental permission, like informed consent, requires that parents be informed of the various treatment options, as well as their risks and benefits, and allows them to make decisions in cooperation with the physician. It differs from informed consent in that it is derived from the obligation shared by the parents and physicians to make decisions in the best interest of the infant, thereby enabling the physician to proceed with a treatment plan without parental permission if doing so is dearly in the best interests of the infant. Ii. Developing a process for ethical decision making. An ethically sound, well-defined, and rigorous process for making decisions in ethically challenging cases is key to avoiding unwanted intervention by a state agency or court. An nicu should define the decision-making process and identify the individuals (nursing staff, primary medical team, subspecialists, social services, ethicists, hospital legal counsel) that may need to participate in that process. Developing this process allows for healthy discussions among nicu personnel that incorporate ethical knowledge and values at a time and place distant from a specific patient. Ideally, this preparation will ease the stress when an actual decision needs to be made. A. Develop an educational program to prepare the nicu caregivers to address difficult decisions regarding patient care. Focus on process (who, when, where) as well as on substance (how). Identifying areas of frequent consensus and disagreement within an nicu and outlining a general approach to those situations can provide helpful guidance. The educational program should be available for nicu staff and discussed during the orientation of new personnel. The hospital ethics committee can serve as an educational resource for personnel regarding how to deal with ethical decision making.

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