Ethical and legal aspects of paediatric surgery

Abstract Paediatric surgeons often have to make, or propose, ethically and legally challenging decisions. Beauchamp’s and Childress’ ‘Four Ethical Principles’ (autonomy, beneficence, non-maleficence, and justice) are often used to justify those decisions. Yet those principles themselves raise many questions, which may have to be solved by recourse to more foundational principles such as dignity. To say what is ‘beneficent’ or ‘non-maleficent’, for instance, might depend on an account of human dignity, This chapter outlines how these and other approaches can be used to approach the issues of consent, capacity, withdrawal and withholding of life-sustaining treatment, confidentiality, and healthcare resource allocation.