Navigating Ethical Crossroads in Pediatric Ophthalmology

Baby J is a 10-month-old infant who presented at birth with bilateral opacification of the cornea and elevated eye pressure. She was diagnosed with a severe form of glaucoma due to a genetic mutation. Her condition can be managed with surgery and daily medications. However, studies on her specific condition report poor outcomes and frequent post-operative complications. Despite receiving the first-line surgeries, Baby J’s pressure remained difficult to control, and her visual prognosis remained uncertain. The parents, who are both blind due to genetic causes, no longer wished to pursue surgical treatment due to their own adverse experiences, and the potential harm of pursuing surgery. Without further intervention, the visual pathways will fail to develop, and Baby J will become blind permanently. The physician, on the other hand, felt pursuing further surgery was a risk worth taking for the chance at achieving a better future for Baby J. This paper discusses Baby J’s case and argues for the safeguarding of parental autonomy following a comprehensive analysis of the case details through the lens of prominent ethical frameworks including the Harm Principle, the Best Interest Standard, and Constrained Parental Autonomy.