Pierre in the Clinic

Dr. Gina Campelia authored an article featured in Pediatric Ethiscope on the common and distressing challenge of disengagement and non-adherence of adolescent patients with chronic disease potentially leading to life-threatening complications. These cases echo Maurice Sendak’s classic children’s story Pierre, which tells the story of a boy who will only say “I don’t care.” When encountering a Pierre case most clinicians intuitively focus on balancing the patient’s emerging autonomy with beneficence and non-maleficence to guide their actions, but these interventions require substantial care labor and may prove unsuccessful, leading to distress or burn out. In Pierre cases we believe ‘good care’ may be better understood through the lens of care ethics. This approach centralizes the wellbeing of the therapeutic clinician-patient relationship itself, which is intrinsic to the practice of pediatrics.