Approach to the Patient: Ethics Cases in Pediatric Endocrinology and Their Management.

CONTEXT: With advancing technologies and expanding indications for existing therapies, ethical dilemmas increasingly arise in pediatric endocrinology practice. AIM: This article presents practical, case-based scenarios to guide clinicians in navigating common ethical challenges in pediatric endocrinology. CASES: We present four case vignettes which present ethical dilemmas regarding (1) growth hormone treatment prescribed for idiopathic short stature, (2) precocious puberty management in a child with neurodevelopmental delay, (3) technology use in type 1 diabetes care, and (4) glucagon-like peptide 1 receptor agonist use for obesity management. For each case, we outline patient presentations and management approaches which highlight the application of the four-principle ethical framework based on Beauchamp and Childress. Salient historical events are mentioned to serve as a basis to contextualize and situate the specific ethical dilemmas. CONCLUSION: Ethical dilemmas have the potential to arise in the everyday practice of pediatric endocrinology. Application of the principles of beneficence, non-maleficence, respect for autonomy, and justice will allow for a pragmatic incorporation of ethical decision making in medical care.