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.
The organ transplantation system is viewed as one of our most equitable health care services, but poor patients are effectively excluded by policy that denies Medicaid coverage of post-transplant immunosuppressant medication.
Physicians should recognize that patients’ beliefs may cause them to have non-medical explanations for their illnesses and that shared explanations should be negotiated if treatment plans are to be successful.
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.
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.