The focus of this dissertation is to create an ethical framework for communication of prognosis in the pediatric critical care setting. This dissertation argues that an ethical framework for communication of prognosis in the pediatric critical care setting is necessary because ethical communication transactions lead to better care for pediatric patients in critical care by enabling surrogate decision makers to make well-informed decisions. Moreover, a lack of effective communication skills can be detrimental to the patient. The need for such a framework is revealed by research indicating that physicians often lack the necessary education and skills for effective communication transactions to transpire.

This dissertation merges communication theory and bioethics to create a practical and ethical framework for communication of prognosis in the pediatric critical care setting. The first chapter provides an introduction. Chapter two addresses communication theory for pediatric medicine. The third chapter introduces the notion of establishing rapport with the ethics of care. Chapter four uncovers how physicians can manage uncertainty in veracity for surrogate consent. The fifth chapter describes the importance of maintaining the physician-family relationship. Chapter six pulls together the literature from the previous chapters to create an ethical framework for communication of prognosis in pediatric critical medicine. Concluding remarks are noted in chapter seven. This dissertation reveals that an ethical framework for communication of prognosis in pediatric critical care medicine is not only necessary, but attainable and can be easily integrated into every day care.