Perspectives in Biology and Medicine

The manuscripts in this issue of Perspectives in Biology and Medicine reflect the work of an international group of pediatric bioethicists and child rights advocates who convened in March 2014 to pursue several questions related to the intersection of pediatric bioethics and child rights. The prequel for the Symposium involved several years of dialogue between the editors of this volume—dialogue through which it became clear that there was much to be learned about our respective disciplines and how they might inform our heretofore mutually exclusive work.

The principles of pediatric bioethics have been used for decades to analyze and help resolve challenging clinical situations in pediatrics, but there has been little exploration of the synergy between our disciplines, despite a parallel movement to translate the principles of child rights into practice. As we began our dialogue, questions arose about how integrating the principles, doctrines, and practice of pediatric bioethics and child rights could contribute to a more robust approach [End Page 247] to the analysis and resolution of contemporary ethical issues in pediatrics, as well as inform the translation of the theory and principles of child rights into practice. While there is currently no clear and general agreement on how to link both perspectives, there is a nascent literature, perhaps most notably advanced by the work of Jonathan Mann (1999), that contributes to our understanding of the extent to which the principles of human rights might enlighten bioethics, and the degree to which those of bioethics could enrich our understanding and practice of human rights advocacy.

Thus, we assembled an international group of bioethicists and human rights advocates to advance the integration of the theory and practice of pediatric bioethics and child rights advocacy. Symposium participants were challenged with the following questions: “Why is it that there has not been explicit engagement with pediatric bioethics on the part of child rights advocates?” and simultaneously, “Why has pediatric bioethics not explicitly integrated the principles of child rights into its work?” Participants were also confronted with the current dichotomy between human rights and medical ethics, as exemplified by the opposing views of George Annas (2005), who suggested that “Medical ethics should overcome the tension and use the Human Rights language that is certainly more robust than the one of medical ethics,” and those of David Benatar (2006), who opined: “The health and human rights paradigm is defective, however, even if the rights in question are moral rather than legal ones. The poverty of this paradigm becomes apparent when we consider what human rights are and how these relate to ethics and bioethics” (19).

From the outset of the Symposium, it was noted that the child rights advocates from Europe, the United States, and South America, and the pediatric bioethicists from the United States and Canada had different perspectives on the relationship between pediatric bioethics and child rights advocacy. A central theme at the Symposium was the meaning of the term rights. It became clear very early on that the meaning and usage of the term rights in the parlance of bioethics and human rights did not fully coincide, and the ensuing discussions revealed substantive gaps in our disciplines’ conceptual frameworks that pose challenges to developing a synergistic relationship between the two groups.

Two days of intense discussions served to generate more questions than answers. The Symposium participants’ commitment to continuing to examine the potential synergy of pediatric bioethics and child rights advocacy, as evidenced by the essays in this issue of Perspectives in Biology and Medicine, is testimony to the group consensus on the importance of this endeavor. And the interest generated among the participants’ colleagues confirms the potential breadth of this commitment. The papers that follow address the critical issues and perspectives identified in the Symposium and serve to introduce readers to the relevant principles of pediatric bioethics and child rights that will support a sustained exploration of the intersection of these disciplines. [End Page 248]