DECEMBER 2015 |฀Volume฀38฀•฀Number฀12 n Feature Article abstract Moral Dilemmas in Pediatric Orthopedics JOHN J. MERCURI, MD, MA; JONATHAN M. VIGDORCHIK, MD; NORMAN Y. OTSUKA, MD All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing or- thopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioeth- ics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthope- dics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pedi- atric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result. [Orthopedics. 2015; 38(12):e1133-e1138.] The authors are from the Hospital for Joint Diseases (JJM, JMV), NYU Langone Medical Center, New York; and The Children’s Hospital at Montefiore (NYO), Montefiore Medical Center, Bronx, New York. The authors have no relevant financial relationships to disclose. Correspondence should be addressed to: John J. Mercuri, MD, MA, Hospital for Joint Diseases, NYU Langone Medical Center, 301 E 17th St, Rm 1402, New York, NY 10003 (john.mercuri@nyumc. org). Received: March 23, 2015; Accepted: May 4, 2015. doi: 10.3928/01477447-20151123-04 e1133