PediPal

Dr. Tasha Faruqui is a pediatrician. Tasha Faruqui is the mother of Soraya, a child with medical complexity who is enrolled in pediatric hospice. For many years, Tasha tried to live two separate lives, worrying about how her identities would conflict with each other. In this episode, she talks with Sarah and Dan about learning to unify herself and how that ultimately made her a better physician and parent.

Learn more about Tasha, Soraya, and their family on Instagram at https://www.instagram.com/thefaruqui5/.

Order Dr. Faruqui's new book, Keep Your Head Up, on her website, https://www.tashafaruqui.com/book or at a bookshop near you.
100% of book proceeds will be donated to Cincinnati Children’s Hospital and the Make-A-Wish Foundation.

Guiding patients and families in complex, high-stakes medical decisions, can we clinicians ever be truly neutral, or are we doomed to always nudge toward our own preferences and biases? How does the architecture of the decisions we present shape the choices that others make? Sarah and Dan tackle these questions and more with three nudging experts: Dr. Aliza Olive (Cleveland Clinic), Dr. Laura Miller-Smith (OHSU), and Dr. Joanna Hart (UPenn).

When all our best attempts fail to relieve suffering, we sometimes turn to palliative sedation to the point of unconsciousness. But how do we know if and when such a drastic intervention is the right choice? Sarah and Dan chat with Justin Baker and Tyler Tate about practical and ethical approaches to communicating about and implementing sedation for pediatric patients facing refractory symptoms at the end of life.

Where do ethics and palliative care overlap, and is there really no harm in doing both? Exercise your autonomy by choosing to listen to this episode, in which your beneficent hosts, Sarah and Dan, get ethical with Phoebe Winn and Bob Macauley, both palliative care physicians whose careers have also brought them to the realm of questions that sometimes just don't have answers. Thankfully, our expert guests are here to help us all understand. I mean, it would hardly be worth listening to if it were just us, right?

Phoebe Winn's recommended ethics readings (click the PMID's for links):
Diekema DS. Parental refusals of medical treatment: the harm principle as threshold for state intervention. Theor Med Bioeth. 2004;25(4):243-64. doi: 10.1007/s11017-004-3146-6. PMID: 15637945. 
Kon AA. Informed non-dissent: a better option than slow codes when families cannot bear to say "let her die". Am J Bioeth. 2011 Nov;11(11):22-3. doi: 10.1080/15265161.2011.603796. PMID: 22047119.
Mercurio MR, Cummings CL. Critical decision-making in neonatology and pediatrics: the I-P-O framework. J Perinatol. 2021 Jan;41(1):173-178. doi: 10.1038/s41372-020-00841-6. Epub 2020 Sep 30. PMID: 32999448.
Diekema DS. Adolescent Brain Development and Medical Decision-making. Pediatrics. 2020 Aug;146(Suppl 1):S18-S24. doi: 10.1542/peds.2020-0818F. PMID: 32737228.
Diekema DS, Botkin JR; Committee on Bioethics. Clinical report--Forgoing medically provided nutrition and hydration in children. Pediatrics. 2009 Aug;124(2):813-22. doi: 10.1542/peds.2009-1299. Epub 2009 Jul 27. PMID: 19651596.
Taub S, Macauley R; COMMITTEE ON BIOETHICS. Responding to Parental Requests for Nondisclosure to Patients of Diagnostic and Prognostic Information in the Setting of Serious Disease. Pediatrics. 2023 Oct 1;152(4):e2023063754. doi: 10.1542/peds.2023-063754. PMID: 37743818.
Really all the AAP Bioethics Guidelines are helpful to know about: https://publications.aap.org/pediatrics/collection/528/Committee-on-Bioethics

And, in case you missed it in Episode 40, Bob Macauley's fabulous new book about his career in palliative care and ethics:  Because I Knew You

There's a member of the pediatric palliative care team we all love but rarely acknowledge: The children's books we share with families that help them cope and process the terrible situations they face. In this episode, Sarah and Dan talk with Joanna Rowland, author of The Memory Box, The Memory Book, and The Memory Tree; and Brennan Wood, author of A Kid's Book About Grief and Executive Director of Portland's Dougy Center (dougy.org).
Click on the links in the titles above to learn more and purchase their books!