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the legal cases that have set precedence for the rights of physicians and surrogates when life-sustaining treatment is withdrawn from patients who cannot make the final decision for themselves.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 have an obligation to consider a patient’s quality of life when making treatment decisions and should consider giving patients the options of withholding or withdrawing aggressive treatment if that treatment will not restore the kind of life the patient finds meaningful.
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.
A physician defends her position that children should only participate in clinical trials when they have child assent and the parents also have been educated about the purpose of the research when there is no direct benefit to the child.