Bereaved Parents and Spouses as Educators in Pediatric Simulation: Ethical Reflections.

Abstract

Bereaved parents and family members are increasingly engaged as educators in simulation-based communication training, particularly in pediatric palliative care. Their lived experience can deepen learners' understanding of serious illness conversations while raising important ethical questions regarding participant well-being, autonomy, and institutional responsibility. To examine the ethical considerations surrounding bereaved family member participation in pediatric simulation through the perspective of a bereaved spouse serving as a parent-actor and medical educator. This ethical analysis draws upon personal experience within an established pediatric palliative care simulation program and applies the principles of beneficence, nonmaleficence, autonomy, and justice to evaluate the opportunities and challenges of incorporating lived experience into communication training. Bereaved family members provide an authenticity that enhances resident learning and encourages more compassionate, family-centered communication. However, meaningful participation requires careful attention to emotional safety, ongoing consent, equitable recognition, and institutional safeguards. Ethical program design includes trauma-informed recruitment, structured preparation and debriefing, appropriate compensation, access to psychological support, and deliberate efforts to broaden participation among diverse family perspectives. The educational value of bereaved family educators depends not simply on their presence but on ethically grounded partnerships that recognize lived experience as expertise. Integrating bereaved family members into simulation programs can strengthen communication training while honoring participant well-being when programs intentionally balance educational benefit with respect, protection, and justice.