title: Should Neonatologists Give Opinions Withdrawing Life-sustaining Treatment?
abstract: An infant has a massive intracranial hemorrhage. She is neurologically devastated and ventilator-dependent. The prognosis for pulmonary or neurologic recovery is bleak. The physicians and parents face a choice: withdraw the ventilator and allow her to die or perform a tracheotomy? The parents cling to hope for recovery. The physician must decide how blunt to be in communicating his own opinions and recommendations. Should the physician try to give just the facts? Or should he also make a recommendation based on his own values? In this article, experts in neonatology, decision-making, and bioethics discuss this situation and the choice that the physician faces.
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: J S
authors.initials: JS
authors.lastname: Blumenthal-Barby
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Laura
authors.initials: L
authors.lastname: Loftis
authors.affiliation: Boston Children's Hospital, Harvard School of Medicine, Boston, Massachusetts.
authors.forename: Christy L
authors.initials: CL
authors.lastname: Cummings
authors.affiliation: University of Chicago, Chicago, Illinois.
authors.forename: William
authors.initials: W
authors.lastname: Meadow
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Monica
authors.initials: M
authors.lastname: Lemmon
authors.affiliation: Duke University, Durham, North Carolina.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Laurence
authors.initials: L
authors.lastname: McCullough
authors.affiliation: Rice University, Houston, Texas; and.
authors.forename: Emily
authors.initials: E
authors.lastname: Rao
authors.affiliation: Children's Mercy Kansas City, Kansas City, Missouri jlantos@cmh.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Lantos
mesh_terms: D000066491:Clinical Decision-Making / Q000941:ethics*; D003657:Decision Making / Q000941:ethics*; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D000072156:Neonatologists / Q000941:ethics; D010819:Physician's Role; D011788:Quality of Life; D016414:Resuscitation Orders / Q000941:ethics*