Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction
- Part I Therapeutic misalliances
- Part II Medical futility
- 4.1 Letting go: a study in pediatric life-and-death decision making
- 4.2 Near-drowning, futility, and the limits of shared decision making
- 4.3 Topical discussion
- 5.1 Long-term ventilation in a child with severe central nervous system impairment
- 5.2 Autonomy, community, and futility: moral paradigms for the long-term ventilation of a severely impaired child
- 5.3 Topical discussion
- 6.1 Complexities in the management of a brain-dead child
- 6.2 The moral arena in the management of a brain-dead child
- 6.3 Topical discussion
- Part III Life by any means
- Part IV Institutional impediments to ethical action
- References
- Index
- References
4.1 - Letting go: a study in pediatric life-and-death decision making
Published online by Cambridge University Press: 18 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction
- Part I Therapeutic misalliances
- Part II Medical futility
- 4.1 Letting go: a study in pediatric life-and-death decision making
- 4.2 Near-drowning, futility, and the limits of shared decision making
- 4.3 Topical discussion
- 5.1 Long-term ventilation in a child with severe central nervous system impairment
- 5.2 Autonomy, community, and futility: moral paradigms for the long-term ventilation of a severely impaired child
- 5.3 Topical discussion
- 6.1 Complexities in the management of a brain-dead child
- 6.2 The moral arena in the management of a brain-dead child
- 6.3 Topical discussion
- Part III Life by any means
- Part IV Institutional impediments to ethical action
- References
- Index
- References
Summary
Introduction
No prospect is more terrifying for parents than being asked to consider the possibility of withdrawing aspects of medical care being provided for their child. Their decision may result in the child's death (Farrell and Levin 1993). Family beliefs, religion, medical science, social values, and the ongoing debate over the importance of individual human life will interact, and sometimes clash, during the process which will culminate in a decision (Luce 1997a, 1997b). The following case illustrates many of the questions which arise, and the difficulty of choosing a clear course of action.
The case of JM
A three-year-old male, JM, wandered into the back yard while his mother was answering the doorbell and fell into the family swimming pool. It took the mother about five minutes to conclude her business with the visitor at the door. When she returned to the back yard, it took her another two to three minutes to notice that JM was missing. She searched the house rapidly, and eventually made the tragic discovery that her son was lying motionless at the bottom of the pool. Initially she panicked, then retrieved him from the water, laid him on the side of the pool, initiated mouth-to-mouth breathing, and then dialed 911 in order to summon help. When the EMS personnel arrived, the child was pulseless and cyanotic. It was believed that he had spent somewhere between 10 and 15 minutes in the water. They performed CPR with a bag-valve-mask device with 100% oxygen.
- Type
- Chapter
- Information
- Ethical Dilemmas in PediatricsCases and Commentaries, pp. 89 - 94Publisher: Cambridge University PressPrint publication year: 2005
References
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