Situations in which the patient’s family seems not to be acting in good faith or the patient's suffering is uncontrollable are relatively rare and do not warrant giving physicians unilateral power to withhold or withdraw treatment in all cases of perceived medical futility.
This month theme issue editor, Trahern Jones, a fourth-year student at Mayo Medical School in Rochester, Minnesota, spoke with Dr. Edward Laskowski about the use of performance-enhancing drugs and substances among athletes today.
When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
Jalayne J. Arias, JD, MA and Kathryn L. Weise, MD, MA
Even when external factors such as nonaccidental injury weigh heavily on clinicians' perceptions, they should not lose focus on the patient's best interest when deciding whether to continue or withdraw treatment.
Is it ethical to create and advertise, either publicly or during office visits, package deals that offer patients an incentive to have procedures they are not already seeking and might not have considered?
Forcing parents to participate in treatment is unlikely to succeed. Seeking to optimize the therapeutic alliance between family and pediatrician is more likely to achieve the desired outcome—the child’s short- and long-term well-being.
Within the patient-physician relationship, the request for neuroenhancement becomes a chief concern, and the physician has a duty to take a history and perform a physical exam to determine whether the patient’s current level of function represents significant change.
Elizabeth Lee Daugherty, MD, MPH and Douglas B. White, MD, MA
Opportunities to advance scientific knowledge may arise during humanitarian crises, but their presence does not justify suspension of the ethical foundations governing human subjects research.