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Fetal Cardiology Bioethics: An Innovative New Curriculum for Cardiology Trainees

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Abstract

Decision-making in fetal cardiology is fraught with ethical issues yet education in bioethics for trainees is limited or nonexistent. In this innovation report, we describe the development of a fetal cardiology bioethics curriculum designed to address this gap. The curriculum was developed to supplement the core curriculum for cardiology fellows and fetal cardiology subspecialty trainees. The series combines didactic and interactive teaching modalities and contains 5 key components: (1) introduction to bioethics and its role in fetal cardiology, (2) counseling and pathways for compassionate terminal care, (3) case vignette-based ethical analysis and discussion cases, (4) fetal counseling considerations for shared decision-making and recommendations, (5) facilitated communications role play. The curriculum was refined using session evaluations from end users. This report describes the innovative curriculum as a starting point for further incorporation and study of bioethical education in pediatric cardiology and fetal training programs.

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Notes

  1. * For a fulsome description of the principlist framework see: Beauchamp TL, Childress JF. Principles of biomedical ethics. (2001) 23. The framework was designed to give equal credence to all four principles and not as a hierarchical or menu selection of applied principles. This has commonly been misconstrued in practice. For additional discussion see also: Kirsch R, Kofarnus M, Madrigal V. Ethics in Pediatric Cardiology and Congenital Heart Disease. (2019) 24.

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Funding

This manuscript did not receive any funding.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada

    Lynne E. Nield, Vitor Guerra, Sonila Mustafa & Lindsay Freud

  2. Department of Pediatrics, University of Toronto, Toronto, Canada

    Lynne E. Nield, Vitor Guerra, Lindsay Freud & Roxanne Kirsch

  3. Sunnybrook Health Sciences Centre, Toronto, Canada

    Lynne E. Nield, Maya Dahan & Nanette Okun

  4. St. Michael’s Hospital, Toronto, Canada

    Ra K. Han

  5. Division Cardiac Critical Care, Department of Critical Care, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Dept Critical Care, Toronto, ON, M5G 1X8, Canada

    Roxanne Kirsch

  6. Department of Bioethics, The Hospital for Sick Children, Toronto, Canada

    Roxanne Kirsch

Authors
  1. Lynne E. Nield
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  2. Maya Dahan
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  3. Vitor Guerra
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  4. Sonila Mustafa
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  5. Nanette Okun
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  6. Lindsay Freud
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  7. Ra K. Han
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  8. Roxanne Kirsch
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Contributions

RK, VG, SM, LEN worked on curriculum design and implementation. RK, LEN, MD wrote the main manuscript text RK, LF, NO assisted in manuscript preparation and feedback for course design and implementation. All authors have reviewed, edited and approved the manuscript.

Corresponding author

Correspondence to Roxanne Kirsch.

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The authors declare no competing interests.

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Nield, L.E., Dahan, M., Guerra, V. et al. Fetal Cardiology Bioethics: An Innovative New Curriculum for Cardiology Trainees. Pediatr Cardiol 45, 703–709 (2024). https://doi.org/10.1007/s00246-024-03431-x

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  • DOI: https://doi.org/10.1007/s00246-024-03431-x

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