1
40
9
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Title
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July 2021 List
Text
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July 2021 List
URL Address
<a href="http://doi.org/10.1136/archdischild-2020-320871" target="_blank" rel="noreferrer noopener">http://doi.org/10.1136/archdischild-2020-320871</a>
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Ethical issues in treatment of babies born at 22 weeks of gestation
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Archives of Disease in Childhood
Date
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2020
Subject
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ethics; neonatal; life sustaining treatment; premature birth; gestational viability
Creator
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Lantos JD
Description
An account of the resource
Many centres now report that more than half of babies born at 22 weeks survive and most survivors are neurocognitively intact. Still, many centres do not offer life-sustaining treatment to babies born this prematurely. Arguments for not offering active treatment reflect concerns about survival rates, rates of neurodevelopmental impairment and cost. In this essay, I examine each of these arguments and find them ethically problematic. I suggest that current data ought to lead to two changes. First, institutional culture should change at institutions that do not offer treatment to babies born at 22 weeks. Second, we need more research to understand best practices for these tiny babies. Copyright © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Identifier
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<a href="http://doi.org/10.1136/archdischild-2020-320871" target="_blank" rel="noreferrer noopener">10.1136/archdischild-2020-320871</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Archives of Disease in Childhood
Ethics
gestational viability
July 2021 List
Lantos JD
Life Sustaining Treatment
Neonatal
premature birth
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
December 2017 List
URL Address
<a href="https://doi.org/10.1542/peds.2017-0690" target="_blank" rel="noreferrer">https://doi.org/10.1542/peds.2017-0690</a>
Notes
Copyright (c) 2017 by the American Academy of Pediatrics.
Dublin Core
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Title
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Cross-Cultural Differences in Communication About a Dying Child.
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2017
Subject
The topic of the resource
Communication; Cross-cultural Comparison; Physician-patient Relations; Attitude To Death/ Ethnology; Child; Humans; Male; Pakistan/ethnology; Subacute Sclerosing Panencephalitis/ Diagnosis/ Ethnology; United States/ethnology
Creator
An entity primarily responsible for making the resource
Cochran D; Saleem S; Khowaja-Punjwani S; Lantos JD
Description
An account of the resource
There are more migrants, refugees, and immigrants adrift in the world today than at any time in the recent past. Doctors and hospitals must care for people from many different cultures, countries, and religious backgrounds. We sometimes find our own deeply held beliefs and values challenged. In this "Ethics Rounds," we present a case in which a Pakistani immigrant family faces a tragic medical situation and wants to deal with it in ways that might be normative in their own culture but are aberrant in ours. We asked the American doctors and 2 Pakistani health professionals to think through the issues. We also invited the father to talk about his own experience and preferences. We conclude that strict adherence to Western ethical norms may not always be the best choice. Instead, an approach based on cultural humility may often allow people on both sides of a cultural divide to learn from one another.
Identifier
An unambiguous reference to the resource within a given context
<a href="https://doi.org/10.1542/peds.2017-0690" target="_blank" rel="noreferrer">10.1542/peds.2017-0690</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Attitude To Death/ Ethnology
Child
Cochran D
Communication
Cross-cultural Comparison
December 2017 List
Humans
Khowaja-Punjwani S
Lantos JD
Male
Pakistan/ethnology
Pediatrics
Physician-patient Relations
Saleem S
Subacute Sclerosing Panencephalitis/ Diagnosis/ Ethnology
United States/ethnology
-
Dublin Core
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Title
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March 2018 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
March 2018 List
URL Address
<a href="http://doi.org/10.1111/bioe.12428" target="_blank" rel="noreferrer">http://doi.org/10.1111/bioe.12428</a>
Dublin Core
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Title
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Fragile lives with fragile rights: Justice for babies born at the limit of viability
Publisher
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Bioethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
Subject
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end-of-life decision-making; gestational age policies; justice; Neonatology
Creator
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Hendriks MJ; Lantos JD
Description
An account of the resource
There is an inconsistency in the ways that doctors make clinical decisions regarding the treatment of babies born extremely prematurely. Many experts now recommend that clinical decisions about the treatment of such babies be individualized and consider many different factors. Nevertheless, many policies and practices throughout Europe and North America still appear to base decisions on gestational age alone or on gestational age as the primary factor that determines whether doctors recommend or even offer life-sustaining neonatal intensive care treatment. These policies are well intentioned. They aim to guide doctors and parents to make decisions that are best for the baby. That is an ethically appropriate goal. But in relying so heavily on gestational age, such policies may actually do the babies a disservice by denying some babies treatment that might be beneficial and lead to intact survival. In this paper, we argue that such policies are unjust to premature babies and ought to be abolished. In their place, we propose individualized treatment decisions for premature babies. This would treat premature babies as we treat all other patients, with clinical decisions based on an individualized estimation of likelihood that treatment would be beneficial.
2018-01
Identifier
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<a href="http://doi.org/10.1111/bioe.12428" target="_blank" rel="noreferrer">10.1111/bioe.12428</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2018
Bioethics
end-of-life decision-making
gestational age policies
Hendriks MJ
Justice
Lantos JD
March 2018 List
Neonatology
-
Dublin Core
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Title
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Oncology
Text
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Citation List Month
Oncology 2017 List
URL Address
<a href="http://doi.org/10.1542/peds.2017-0487" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2017-0487</a>
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Title
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Palliative Sedation With Propofol for an Adolescent With a DNR Order
Publisher
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Pediatrics
Date
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2017
Creator
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Johnson Liza-Marie; Frader J; Wolfe J; Baker JN; Anghelescu Doralina L; Lantos JD
Description
An account of the resource
Death from cancer is often painful. Usually, the pain can be relieved in ways that allow patients to remain awake and alert until the end. Sometimes, however, the only way to relieve pain is to sedate patients until they are unconscious. This method has been called palliative sedation therapy. Palliative sedation therapy is controversial because it can be misunderstood as euthanasia. We present a case in which an adolescent who is dying of leukemia has intractable pain. Experts in oncology, ethics, pain management, and palliative care discuss the trade-offs associated with different treatment strategies.
Identifier
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<a href="http://doi.org/10.1542/peds.2017-0487" target="_blank" rel="noreferrer">10.1542/peds.2017-0487</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Anghelescu Doralina L
Baker JN
Frader J
Johnson Liza-Marie
Lantos JD
Oncology 2017 List
Pediatrics
Wolfe J
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2013-0413" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2013-0413</a>
<a href="http://pediatrics.aappublications.org/content/early/2013/10/02/peds.2013-0413" target="_blank" rel="noreferrer">http://pediatrics.aappublications.org/content/early/2013/10/02/peds.2013-0413</a>
Dublin Core
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Title
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When Life-Sustaining Treatment Is Withdrawn and the Patient Doesn’t Die
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
Subject
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Palliative Care; Palliative Care; Ethics; prognostication; withdrawal of life-sustaining treatment
Creator
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Kutzsche S; Partridge JC; Leuthner SR; Lantos JD
Description
An account of the resource
One of the most difficult decisions that doctors and parents must make is the decision to withdraw life-sustaining treatment. Doctors find it easier to withdraw treatments in situations where withdrawal will be rapidly fatal rather than in situations in which treatment withdrawal will lead to a prolonged dying process. Mechanical ventilation is usually such a treatment. Withdrawal of ventilation generally leads to the patient’s rapid demise. Doctors may tell parents that death will occur quickly after a ventilator is withdrawn. But what happens when the doctors are wrong and a patient survives without life support? What should doctors do next? We present a case in which that happened and asked 3 experts to comment on the case. Stefan Kutzsche is a senior consultant in neonatology at Oslo University Hospital Ulleval in Norway. John Colin Partridge is a neonatologist and professor of pediatrics at University of California, San Francisco. Steven R. Leuthner is a neonatologist and professor of pediatrics and bioethics at the Medical College of Wisconsin. They each recommend slightly different approaches to this dilemma.
2013-10
Identifier
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<a href="http://doi.org/10.1542/peds.2013-0413" target="_blank" rel="noreferrer">10.1542/peds.2013-0413</a>
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Type
The nature or genre of the resource
Journal Article
2013
Backlog
Ethics
Journal Article
Kutzsche S
Lantos JD
Leuthner SR
Palliative Care
Partridge JC
Pediatrics
prognostication
withdrawal of life-sustaining treatment
-
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Title
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January 2023 List
Text
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Citation List Month
January List 2023
URL Address
<a href="http://doi.org/10.1080/15265161.2022.2123984" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1080/15265161.2022.2123984</a>
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Title
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Should We Aspire to Be Rational About Letting Babies Die?
Publisher
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The American Journal of Bioethics
Date
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2022
Subject
The topic of the resource
Death; Infant; Rational
Creator
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Lantos JD
Identifier
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<a href="http://doi.org/10.1080/15265161.2022.2123984" target="_blank" rel="noreferrer noopener">10.1080/15265161.2022.2123984</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Death
2022
Infant
January List 2023
Lantos JD
Rational
The American Journal Of Bioethics
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2013-4161" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2013-4161</a>
<a href="http://pediatrics.aappublications.org/content/early/2014/08/12/peds.2013-4161" target="_blank" rel="noreferrer">http://pediatrics.aappublications.org/content/early/2014/08/12/peds.2013-4161</a>
Dublin Core
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Title
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Mechanical Ventilation for a Child With Quadriplegia
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
Subject
The topic of the resource
quality of life; Ethics; decisional capacity; quadriplegia; right to refuse treatment; substituted judgment
Creator
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Novotny WE; Perkin RM; Mukherjee D; Lantos JD
Description
An account of the resource
Parents generally have the right to make medical decisions for their children. This right can be challenged when the parents’ decision seems to go against the child’s interests. The toughest such decisions are for a child who will survive with physical and neurocognitive impairments. We discuss a case of a 5-year-old boy who suffered a spinal injury as a result of a motor vehicle accident and whose father requests discontinuation of life support. Many experts recommend a “trial of therapy” to clarify both prognosis and quality of life. The key ethical question, then, is not whether to postpone a decision to forego mechanical ventilation. Instead, the key question is how long to wait. Parents should be allowed time to see what life will be like for themselves and for their child. Most of the time, life turns out better than they might have imagined. Comments are provided by 2 pediatric intensivists, Drs William Novotny and Ronald Perkin of East Carolina University, and by a specialist in rehabilitation, Dr Debjani Mukherjee of the Rehabilitation Institute of Chicago.
2014-08
Identifier
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<a href="http://doi.org/10.1542/peds.2013-4161" target="_blank" rel="noreferrer">10.1542/peds.2013-4161</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2014
Backlog
decisional capacity
Ethics
Journal Article
Lantos JD
Mukherjee D
Novotny WE
Pediatrics
Perkin RM
quadriplegia
Quality Of Life
right to refuse treatment
substituted judgment
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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October 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
October 2022 List
URL Address
<a href="http://doi.org/10.1542/peds.2021-055558">http://doi.org/10.1542/peds.2021-055558</a>
Dublin Core
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Title
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Disposition Decisions in Cases of Medical Complexity and Health Inequity
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Subject
The topic of the resource
Adult; Covid-19; Child; Ethics; Clinical; Health; Inequities; Humans; Palliative Care; Pandemics
Creator
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Shapiro J P; Anspacher M; Madrigal V; Lantos JD
Description
An account of the resource
The question of optimal disposition for children with complex medical and social circumstances has long challenged the well-intentioned clinician. The coronavirus disease 2019 pandemic created unique difficulties for patients, families, and health care providers, in addition to highlighting long-standing racial and socioeconomic inequities in health care. In pediatric hospitals, necessary public health measures such as visitor restrictions shifted many shared decision-making processes such as discharge planning from complicated to impossible. Here, we present the case of a medically complex adult (with a long-standing pediatric condition) whose surrogate decision-maker objected to discharge to a long-term care facility because of restrictions and risks associated with the coronavirus disease 2019 pandemic. We offer the commentary of experts in clinical ethics, intensive care, inpatient subacute care, and palliative care. Our discussion includes analysis of the ethical considerations involved in the case, concrete guidance on steps toward an ethically permissible discharge, and suggestions for how a health equity lens can improve communication and decision-making for families who are victims of systemic racism and economic discrimination.
Identifier
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<a href="http://doi.org/10.1542/peds.2021-055558">10.1542/peds.2021-055558</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2022
Adult
Anspacher M
Child
Clinical
COVID-19
Ethics
Health
Humans
Inequities
Lantos JD
Madrigal V
October 2022 List
Palliative Care
Pandemics
Pediatrics
Shapiro J P
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1038/jp.2014.170" target="_blank" rel="noreferrer">http://doi.org/10.1038/jp.2014.170</a>
<a href="http://www.nature.com/jp/journal/vaop/ncurrent/full/jp2014170a.html" target="_blank" rel="noreferrer">http://www.nature.com/jp/journal/vaop/ncurrent/full/jp2014170a.html</a>
Dublin Core
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Title
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Does diagnosis influence end-of-life decisions in the neonatal intensive care unit?
Publisher
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Journal Of Perinatology
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
Creator
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Weiner J; Sharma J; Lantos JD; Kilbride H
Description
An account of the resource
Objective: Study Design: Result: Conclusion:
2014-09
Identifier
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<a href="http://doi.org/10.1038/jp.2014.170" target="_blank" rel="noreferrer">10.1038/jp.2014.170</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2014
Backlog
Journal Article
Journal Of Perinatology
Kilbride H
Lantos JD
Sharma J
Weiner J