Ethical Decision-Making in Pediatric Oncology Treatment: Considering Multidisciplinary Ethics to Optimize Mental and Physical Health Outcomes

Pediatric psychologists face unique ethical challenges in medical settings, especially in oncology, where psychological, social, and medical factors intersect. This case report explores the application of psychological and medical ethical principles in the care of a psychiatrically complex pregnant adolescent newly diagnosed with cancer. We present a case study of a 15-year-old pregnant female, “Jane,” with newly diagnosed high-grade osteosarcoma, posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder. A multidisciplinary team collaborated to guide decision-making during an acute stage of treatment. Psychological and medical ethical frameworks informed treatment planning. Ethical tensions included balancing maternal and fetal health, aligning conflicting goals of care, and navigating barriers to effective communication. Additionally, conflicting legal and ethical obligations are addressed. Oncology treatment decisions were supported through multidisciplinary collaboration, ethics and legal consultation, and psychological conceptualization and recommendations. Psychology played a critical role in assessing and supporting psychological coping, facilitating family communication, and mitigating psychological harm during an acute and distressing phase of care. This case underscores the need for integrated psychological care in pediatric oncology, particularly when ethical dilemmas arise with complex patients. Pediatric psychologists are uniquely positioned to inform ethical decision-making by contextualizing psychological history, assessing risk, and facilitating communication.