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.
Guidelines for proceeding with a plan of care when family members have conflicting opinions about the patient’s wishes and the patient does not speak the same language as her physicians.
Medical malpractice pits the legal system's ethics of client advocacy against the medical profession's ethics of patient advocacy. Fear of liability may lead to defensive medicine, an aberration of both professions' intent.
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.
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 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.
Parents' ability to make medical decisions for their children can be limited by state law if it is determined that the child's best interest is not being met.