Introduction: Childhood and Disability

Abstract

From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care. As the introduction to HEC Forum's special thematic issue on Childhood and Disability, this article orients the reader to the history of bioethics' relationship to both pediatric ethics and disability studies and introduces the issue's five manuscripts. As clinicians, disability scholars, philosophers and clinical ethicists writing on various aspects of pediatric disability, the articles' authors all invite readers to dig beneath an overly-simplified version of what disability might mean to children and families and instead embrace a posture of genuine humility, recognizing both the limits and harms of traditional medical and bioethical responses (or indifferences) to the disabled child.Keywords Childhood Á Pediatrics Á Disability Á Quality of life Á Disability paradox While questions concerning medical care for individuals with disabilities have never been far from the pediatric clinic, several critical events within the past few decades have invited increasing discussion about the nature and role of disability within the context of pediatric care. First came the widely-publicized cases of two handicapped infants in the early-mid 1980s-Baby Doe and Baby Jane Doe-for whom