Iranian Journal of Medical Ethics and History of Medicine

Nurses are committed to protecting the rights of their patients. However, significant challenges often arise in their communication with physicians and patients. In some situations, nurses feel that patient autonomy is not respected, and sufficient, appropriate information is not provided to patients and their families. These challenges are particularly pronounced in pediatric nursing, as children often cannot fully express their needs. Pediatric nurses must be especially sensitive to the vulnerability of children and their families, actively supporting their welfare and best interests. When a child is suffering from a serious illness or nearing the end of life, the ethical challenges become even more complex. Some of these challenges include:
- How should healthcare decisions be made for these children?
- Who should make these decisions?
- How is the best interest of these children determined?
- Who can best advocate for children's rights?
- When treatment involves life-sustaining therapies (LST), is preserving life more important than ensuring quality of life?
- Who has the authority to transition from therapeutic or life-sustaining interventions to palliative care?

To address these challenges, nursing associations in various countries have developed ethical charters. However, no universal consensus or definitive solutions exist for navigating these complex clinical situations. Consulting experts across different fields and developing comprehensive professional ethics codes can serve as valuable guidance for pediatric nurses making ethical decisions in cases of serious illness.