Consent in Pediatric Critical Care Trials: Duty or Burden?

Consent in Pediatric Critical Care Trials: Duty or Burden?
Editorial
Mark J. Peters, Kate Plant
Pediatric Critical Care Medicine, September 2024
Excerpt
    Clinical practice is highly variable. Some of our colleagues use more maintenance fluids than we would choose for our patients. Or we might continue antibiotics beyond when they would stop them. We suspect any reader could think of similar examples in their own teams.
We currently accept this variability as commonplace in a complex setting such as a PICU. After all, there are tens, if not hundreds, of minor management decisions for each patient each day (1). If there were no differences between clinicians, our job could be replicated by robots or at least protocolized. There is a reasonable argument that this variability brings an additional level of safety. Practice regresses toward a mean such that over the duration of an admission any more extreme requests by one clinician will tend to be moderated by the colleague who takes over on the following shift.
Although we share our decision-making and plans with parents and patients where appropriate, we do not typically seek consent for these small variations in practice between staff…