Nonlegal, judicial, and statutory courses of action are available to patient surrogates and physicians who cannot agree on withdrawal of life-sustaining treatment.
Anne-Marie Laberge, MD, MPH and Wylie Burke, MD, PhD
Two physicians examine the risks of testing minor children for late-onset genetic diseases when there is no current benefit and explain why several medical associations oppose the practice.
A bioethicist argues that children with Down syndrome should not be subjected to cosmetic surgery to change their appearance unless they are at the age and have the capacity to make the decision for themselves.
Physicians should be aware of the level of emotional distress and suffering that a patient is experiencing as a result of his or her illness and incorporate that into the patient's treatment plan.
Physicians should demonstrate compassion when the parent of an ill child asks the physician for his or her personal opinion regarding the parents' choice to continue experimental treatment when the prognosis is not good.
Physicians who treat children with Down's syndrome should ensure that their parents fully understand the children's capabilities and long-term prognosis and counsel them on the appropriate actions to take regarding their children's care.
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.
Lorraine M. Stone, MD, MSPH and James A. Tulsky, MD
Physicians should develop a specific strategy for talking to relatively healthy patients about their CPR preferences in the event they become seriously ill in the future.