Unilateral Withdrawal of Life-sustaining Therapy in a Severely Impaired Child

Author:

Miller Kathryn E.1,Coleman Ryan D.2,Eisenberg Leah3,Henriksen Joan4,Lantos John D.5,Weiss Elliott Mark67

Affiliation:

1. Division of Pediatric Critical Care, Department of Pediatrics, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, Ohio;

2. Sections of Pediatric Critical Care Medicine and Pulmonary Medicine, Department of Pediatrics and Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas;

3. Division of Medical Humanities, University of Arkansas for Medical Sciences, Little Rock, Arkansas;

4. Office of Clinical Ethics, Mayo Clinic, Rochester, Minnesota;

5. Center for Bioethics, Children’s Mercy Hospital, Kansas City, Missouri;

6. Division of Neonatology, Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington; and

7. Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Hospital and Research Institute, Seattle, Washington

Abstract

An infant with complex congenital heart disease suffers a prolonged cardiac arrest with minutes of anoxia. He is left with severe brain damage and profound neurologic impairment. He no longer responds to caregivers. Much of the time, he cries and grimaces as if in pain. He has required increasing sedation to control these symptoms. His parents live hours from the hospital and seldom visit. When their infant’s situation is explained to them over the telephone, they request that doctors “do everything to keep him alive.” His bedside caregivers report high levels of moral and psychological distress and frequently discuss J.S.’s “suffering.” An ethics consultation is requested, asking whether it is permissible to withdraw life support despite the parents’ request that therapy continue.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference10 articles.

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2. Legal briefing: stopping nonbeneficial life-sustaining treatment without consent.;Pope;J Clin Ethics,2016

3. Resolution of futility by due process: early experience with the Texas Advance Directives Act.;Fine;Ann Intern Med,2003

4. Which child will live or die in France: examining physician responsibility for critically ill children.;Carnevale;Anthropol Med,2007

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4. Pediatric Suffering and the Burden of Proof;Pediatrics;2020-07-31

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