Breaking Bad News and Building Trust: BelSU Trains Paediatricians in Medical Ethics

Students from Belgorod Natiional Research University (BelSU) gathered for a roundtable discussion on Ethical Aspects of Paediatric Practice, held at the Department of Paediatrics under the direction of Elena Balakireva, DMedSc. The conversation focused on the professional interactions between paediatricians and young patients and their families – topics that demand not only deep knowledge but also exceptional tact, sensitivity and responsibility.

Speakers included Galina Pyatykh, Children’s Rights Commissioner for the Belgorod Region; Dr Tatyana Shalneva, Chief Paediatrician of the Ministry of Health of the Belgorod Region; and Alina Balakireva, Assistant Professor in the Department of Paediatrics.

Dr Shalneva discussed protocols for informing parents of a serious diagnosis. Commissioner Pyatykh shared her experience in professionally resolving complex ethical dilemmas that touch on both moral and legal aspects of doctor‑patient‑family interactions.

“Every doctor, especially paediatricians, must possess mediation skills – resolving conflict situations – and listen to the opinions of both the young patient and their parents,” said Pyatykh. “However, without giving in to their wishes, we must take appropriate action to preserve the child’s health.”

Alina Balakireva highlighted the nuances of medical students’ work with children and raised controversial issues regarding the management of social media accounts by future paediatricians.

During a lively discussion, students addressed pressing questions: Is it acceptable to cover clinical cases in the media? Where are the boundaries of using educational materials? How do legal permissibility and ethical validity relate in the actions of healthcare professionals? The discussion revealed that many ethical issues have no clear‑cut solutions and require future paediatricians to develop a professional mindset grounded in respect for the patient, upholding their rights, and maintaining trust.

All participants concluded that medical ethics in paediatrics is both a set of regulatory requirements and a system of value guidelines that shape physician behaviour in the professional environment. Such meetings contribute to developing students’ professional identity and the skills for responsible, ethical interactions in medical practice.

“Paediatric practice extends far beyond purely clinical work with children and inevitably includes interactions with parents – their expectations, anxieties and emotional state,” emphasised Dr Elena Balakireva. “Under these conditions, questions of medical ethics and deontology take on particular significance, becoming not a theoretical basis but a practical tool for a physician’s daily work.”