Are we going to talk about it?
Anonymous Note: The author chose to submit anonymously because of threatening experiences with those that held different opinions. It is our hope that this PAAD will catalyze a necessary conversation.
I LOVE going to SPA meetings. My inner and often outer extrovert loves the education, networking, and comradery. I am re-energized being with my colleagues- which is why it was so hard to not have attended this year’s conference in Texas and why I will not attend in 2025 when SPA is scheduled to take place in Florida. While I don’t want to talk about politics in medicine, the politics have made it impossible to sit quietly any longer. There are states in this country that have become unsafe places for our patients, our colleagues, and for me. So, as I opened a series of PAADs and saw the shining faces of SPA members having a blast in Austin, several questions ran through my mind. Who else is thinking about this? Who else isn’t there? Is our organization going to say anything? When are we going to talk about how conference location directly impacts the Society of Pediatric Anesthesia?
The annual meetings of The Society of Pediatric Anesthesia have long been incredible opportunities for physicians to learn and grow in our specialty. Attendance at these conferences affords a wealth of networking opportunities for interested, aspiring, early career, and veteran pediatric anesthesiologists. The connections made at SPA can lead to new jobs, educational innovations, research collaborations, support, and guidance in a challenging field. The advantages provided by attending annual conferences is why so many of us look forward to these events, and as we look to what our field can be, it is why it is so important to make these conferences as inclusive to as many members as possible.
Recently some states have become unsafe places for access to life-saving treatments related to pregnancy. In holding meetings in these locations, people who are pregnant may be unable to receive the healthcare interventions they could have should an unexpected and unimaginable emergency occur that could jeopardize their health.
The states of Texas and Florida have passed laws limiting the rights and safety of transgender people. In Florida a transgender individual can be arrested for using “the wrong bathroom. State law also supports the right of healthcare providers withholding medical care to certain individuals based on religious views. Imagine our colleagues being placed in that situation? Some have pointed out that bias and bigotry can be found anywhere and while that’s true, not everywhere is it supported by the law. How can we truly upstand for our colleagues if standing up is against a police officer with the state law on their side?
We have put so much effort into calling attention to the bias and lack of diversity in our specialty and we must look at what conference location selection does to the attendance at our meetings. Who can safely come? Who are we excluding? Who will lose? While supporting our patients, our colleagues, and ourselves is of primary concern, I also worry about the future of our field. How can we attract the best and brightest and the most innovative and diverse thinkers and researchers if we are excluding populations? While it may not be SPA’s intention to exclude members of our community, by holding conferences in which some in our community cannot attend effectively results in exclusion.
SPA’s mission statement encourages us to advance “the safety and quality of anesthesia care...in children by educating clinicians, supporting research, and fostering collaboration among clinicians, patient families, and professional organizations worldwide.” Societies of our medical community (AMA, ACOG) have come out against the restrictive laws on women’s reproductive health as being unsafe and not in the best interest of patient safety. The AAP and AMA have made statements in support of gender affirming care. The data clearly supports that access to reproductive health care and gender affirming care further the health and safety of our patients. SPA’s own statement on transgender care affirms that “[as] perioperative medical professionals and patient safety advocates, we have a duty to protect and care for vulnerable pediatric populations… Now is the time to stand up, make our voices heard, and uphold our ethical standards in the face of injustice.” As members of SPA, let us remind ourselves and SPA leadership of this call. Let us stand up for our patients, our friends, our colleagues, and ourselves and no longer support holding conferences in locations where the law places us at exclusion, discrimination, and harm.
Morphine and hydromorphone dosing error. Thanks to several readers including Dr. Adaora M. Chima and Dr Benoît BEAUVE who found a dose conversion error in today’ PAAD. As we stated in the PAAD, hydromorphone is 5 times more potent than morphine, thus, 10 mg IV morphine = 2 mg IV hydromorphone. In a line in today’s PAAD we had it reversed in which we wrote “morphine and hydromorphone (0.05 mg/kg v 0.2 mg/kg respectively”…it should be reversed: “hydromorphone and morphine (0.05 mg/kg v 0.2 mg/kg respectively”