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Some hospitals have attempted to adapt to this scarcity by using hand-bag ventilation, as either a bridge to a mechanical ventilator, or until clinical improvement occurs rendering mechanical ventilation no longer necessary. In instances of hand-bag ventilation, an endotracheal tube is first placed. Family members are then asked to play the role of a ventilator, manually compressing a bag repeatedly to inflate the child\u2019s lungs. This approach is fraught with numerous ethical challenges. A careful examination of the data and a nuanced approach to the ethical considerations are imperative. Ethical arguments in support of and in opposition to allowing parental hand-bag ventilation are explored, including the best interests of the child, the child\u2019s right to an open future, beneficence and parental protection, legitimising substandard care, and finally, contextual concerns. An algorithmic, potentially ethically permissible approach to parental participation in manual ventilation is proposed.<\/jats:p>","DOI":"10.1136\/medethics-2019-105992","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T21:17:29Z","timestamp":1588799849000},"page":"459-464","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Parental manual ventilation in resource-limited settings: an ethical controversy"],"prefix":"10.1136","volume":"46","author":[{"given":"Emily","family":"Barsky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadath","family":"Sayeed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"issue":"10100","key":"2024111107401115000_46.7.459.1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/S0140-6736(17)32152-9","article-title":"Global, regional, and national age-sex specific mortality for 264 causes of death, 1980\u20132016: a systematic analysis for the global burden of disease study 2016","volume":"390","author":"Naghavi","year":"2017","journal-title":"The Lancet"},{"key":"2024111107401115000_46.7.459.2","unstructured":"WHO . 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