The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Physicians should seriously weigh the benefits and risks involved prior to discussing the possibility of genetic testing with a patient or referring them to a genetic counselor.
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 go beyond basic medical diagnosis and treatment to offer support to families about the gamut of social and emotional issues that are involved with caring for a severely disabled child.