Chris Feudtner, MD, PhD, MPH, David Munson, MD, and Wynne Morrison, MD
The way that we choose how to frame the conversation with parents about halting or continuing such therapy for their children who will not recover has special importance in medicine and in society.
An examination of some of the factors that can weaken the therapeutic nature of the patient-physician relationship and how a physician can resolve them in the patient's best interest.
Medical technology presents a new ethical question in the case of a patient with a left ventricular assist device who, when informed that he has pneumonia and is ineligible for a heart transplant, asks that the LVAD be turned off.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.