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生物,工程和医学的道德
SJR: 0.123

ISSN 打印: 2151-805X
ISSN 在线: 2151-8068

生物,工程和医学的道德

DOI: 10.1615/EthicsBiologyEngMed.2016013733
pages 187-196

Ethical Perspectives: Withdrawal of Life-Sustaining Treatments in Pediatrics

Danielle Brigham
Cohen Children's Medical Center, New Hyde Park, New York
Shefali Karkare
Cohen Children's Medical Center, New Hyde Park, New York
Linda Siegel
Cohen Children's Medical Center, New Hyde Park, New York

ABSTRACT

One circumstance that families may have to encounter in a pediatric setting is withdrawal of life-sustaining treatment (WLT). When a situation involves WLT, the four fundamental principles of ethics often conflict. These principles are respect for autonomy, beneficence, nonmaleficence, and justice. In cases where WLT occurs, physicians have to ask, Are we doing more harm by keeping a patient alive versus withdrawing care? Does autonomy and justice trump beneficence and nonmaleficence, or vice versa? Is it possible to evaluate which factors are more important?
This article reflects a comparison of two pediatric case studies. The first case involved a 7-month-old female diagnosed with acute disseminated encephalomyelitis (ADEM). The family requested withdrawal of care; however, the medical team suggested a prolonged treatment course. In the second pediatric case, a 1-month-old infant with hypoxic ischemic encephalopathy (HIE), medical staff recommended WLT, and the family consented with this course of action. However, both cases involved difficult conflicts between the families and the medical teams caring for the patients.
These cases are compared and evaluated against the four principles of ethics. In addition, the cost and burden of prolonging life are assessed from the perspective of the patient, the family, and the medical staff providing care.


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