Abstract:
Pediatricians practice at the intersection of medical science, community trust, and societal change. Over a 35-year career as a chief pediatrician in central Ukraine, I worked through late-Soviet state medicine, the transition to independence, economic instability, multiple waves of political reform, and the profound disruptions of armed conflict. Throughout these changes, the ethical foundations of pediatric care, advocacy for children, protection of the vulnerable, professional autonomy, and trust between families and clinicians, were repeatedly tested and reshaped.
This presentation examines how shifting political systems, resource scarcity, and conflict conditions influence pediatric ethics and decision-making. Drawing on clinical leadership experience, frontline service during governmental changes, and personal perspectives as a clinician, mother, and grandmother, I describe the moral tensions inherent in caring for children when institutional structures collapse and societal priorities shift.
By reflecting on lived experience across historical eras, I argue that pediatric ethics cannot remain static. Instead, resilience requires ethical adaptability grounded in core values: unwavering commitment to child welfare, transparency with families, protection of clinical integrity, and sustained advocacy for children’s rights. In conflict-affected settings, ethical leadership must extend beyond hospitals into policy, education, and community networks to safeguard the physical and emotional health of future generations.
My aim is to contribute practical insights for pediatricians facing uncertainty, political pressure, rapid social change, or crises, including pandemics and war. Ethics in pediatrics is not only a professional framework but a lifelong compass that guides us through the world’s shifting landscapes while keeping children at the center of care.
