Trust-based beneficence and relational autonomy in neonatal ethics
Monash Bioethics Review, cilt.44, sa.1, ss.117-128, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 44 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s40592-026-00282-5
- Dergi Adı: Monash Bioethics Review
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE, Philosopher's Index, Philosopher's Index full-text, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.117-128
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Parental refusal of newborn preventive treatments, such as vitamin K injections and hepatitis B vaccines, presents a growing ethical dilemma at the intersection of autonomy, beneficence, and public trust. While respecting parental decision-making remains a cornerstone of liberal bioethics, clinicians are equally obliged to protect the infant’s welfare and uphold public health standards. This paper introduces a trust-centred model of beneficence, blending relational ethics and distributive justice to guide clinicians through the ethical complexities of such refusals. Drawing upon current research in bioethics, paediatrics, and public health, we explore three core dimensions: (1) the knowledge gap, also known as epistemic asymmetry, between clinicians and parents; (2) trust as a moral foundation in clinical relationships; and (3) the broader public health implications of neonatal care. We argue that clinicians must move beyond a purely harm-avoidant stance and adopt a responsibility for nurturing trust and solidarity within healthcare. This model advocates for ethical, limited paternalism rooted in open dialogue, empathy, and evidence-based reassurance. Rather than interpreting parental refusal as defiance, it reframes it as an expression of broken trust, a call for repair rather than coercion. In doing so, it aligns the immediate wellbeing of the infant with the broader, long-term moral framework that upholds public confidence in medicine.