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Comment & Response
September 2017

Extending the Social Justice Call to Treatment Outcomes

Author Affiliations
  • 1Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore
JAMA Pediatr. 2017;171(9):913. doi:10.1001/jamapediatrics.2017.1903

To the Editor Kudos to Racine for calling the pediatric community to consider its role in a social justice framework.1 His call should extend to all of us in the pediatric research community as well. Further, I propose that it is even more critical where mental health treatment of the poor may result in overtreatment. Applying John Rawls’ ethical decision model to assure a just mental health treatment decision means forming a decision without knowing whether the child is poor and socially deprived or well off in a socially privileged environment or whether the caregiver is a foster parent or the pediatrician’s or researcher’s daughter. Most critically, a just decision may depend on the prescriber’s greater proportional responsibility for a continually evolving awareness of the strengths and limitations of the pediatric pharmacologic and treatment knowledge base as treatments are used over time.

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