title: Tough Decisions for Premature Triplets.
abstract: When infants are born at the borderline of viability, doctors and parents have to make tough decisions about whether to institute intensive care or provide only palliative care. Often, these decisions are made in moments of profound emotional turmoil, and parents receive different information from different health professionals. Communication can become garbled. It may be difficult to tell when and whether the patient's clinical condition has changed enough so that certain choices that had once been permissible become impermissible. In this "Ethics Rounds," we present a case of triplets born at the borderline of viability. We sought comments from the triplets' parents, the doctors and ethicist who were caring for the infants, and a bioethicist/neonatologist from another hospital.
authors.affiliation: University of Virginia, Charlottesville, Virginia;
authors.forename: Ashley
authors.initials: A
authors.lastname: Hurst
authors.affiliation: University of Virginia, Charlottesville, Virginia;
authors.forename: Brooke D
authors.initials: BD
authors.lastname: Vergales
authors.affiliation: University of Virginia, Charlottesville, Virginia;
authors.forename: Alix
authors.initials: A
authors.lastname: Paget-Brown
authors.affiliation: Yale University, New Haven, Connecticut; and.
authors.forename: Mark
authors.initials: M
authors.lastname: Mercurio
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri, Kansas City, Missouri jlantos@cmh.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Lantos
mesh_terms: D003657:Decision Making / Q000941:ethics; D033061:Ethics Consultation; D005260:Female; D005328:Fetal Viability; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000941:ethics*; D008297:Male; D010166:Palliative Care / Q000941:ethics; D010290:Parents; D012151:Resuscitation; D014310:Triplets; D028761:Withholding Treatment / Q000941:ethics*