Frank A. Chervenak, MD and Laurence B. McCullough, PhD
Clinical facts and physicians’ ethical obligations are critical in resolving disagreements between parents and physicians about resuscitation of an extremely premature infant.
Nonlegal, judicial, and statutory courses of action are available to patient surrogates and physicians who cannot agree on withdrawal of life-sustaining treatment.
A summary of the legal cases that have set precedence for the rights of physicians and surrogates when life-sustaining treatment is withdrawn from patients who cannot make the final decision for themselves.
Physicians should fully understand the ethical principles and professional standards involved in making decisions for the treatment of impaired newborns.
Parents' ability to make medical decisions for their children can be limited by state law if it is determined that the child's best interest is not being met.
Physicians should go beyond basic medical diagnosis and treatment to offer support to families about the gamut of social and emotional issues that are involved with caring for a severely disabled child.
Physicians are held legally responsible if patients are harmed by not receiving the care that is required, even when the restriction of that care is imposed by a third-party payor.
Physicians should help patients resolve the issue of medical debt by advocating for change in the health care system on a local and national level and implementing charity care within their offices.