Ethical Aspects of Personalized Research and Management of Systemic Inflammatory Response Syndrome (SIRS) in Children

Int J Environ Res Public Health. 2022 Dec 28;20(1):470. doi: 10.3390/ijerph20010470.

Abstract

Systemic inflammatory response syndrome (SIRS) is a life-threatening condition with nonspecific symptoms. Because of that, defining a targeted therapy against SIRS in children and adults remains a challenge. The identification of diagnostic patterns from individualized immuneprofiling can lead to development of a personalized therapy. The aim of this study was to identify and analyze ethical issues associated with personalized research and therapy for SIRS in pediatric populations. We conducted an ethical analysis based on a principled approach according to Beauchamp and Childress' four bioethical principles. Relevant information for the research objectives was extracted from a systematic literature review conducted in the scientific databases PubMed, Embase and Web of Science. We searched for pertinent themes dealing with at least one of the four bioethical principles: "autonomy", "non-maleficence", "beneficence" and "justice". 48 publications that met the research objectives were included in the thorough analysis, structured and discussed in a narrative synthesis. From the analysis of the results, it has emerged that traditional paradigms of patient's autonomy and physician paternalism need to be reexamined in pediatric research. Standard information procedures and models of informed consent should be reconsidered as they do not accommodate the complexities of pediatric omics research.

Keywords: SIRS; child; clinical ethics; personalized medicine; research ethics; systemic inflammatory response syndrome.

Publication types

  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Beneficence
  • Child
  • Humans
  • Informed Consent*
  • Personal Autonomy
  • Systemic Inflammatory Response Syndrome* / therapy

Grants and funding

The research was financially supported by the German Federal Ministry of Education and Research within the framework of the sponsor consortium ERA PerMed for the research project “Tailored Immunotherapy for Paediatric SIRS” (TIPS).