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John D. Lantos [79]John Lantos [37]
  1.  13
    Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?Marlyse F. Haward, Annie Janvier, Gregory P. Moore, Naomi Laventhal, Jessica T. Fry & John Lantos - 2020 - American Journal of Bioethics 20 (7):37-43.
    In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing...
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  2.  46
    Should the “Slow Code” Be Resuscitated?John D. Lantos & William L. Meadow - 2011 - American Journal of Bioethics 11 (11):8-12.
    Most bioethicists and professional medical societies condemn the practice of ?slow codes.? The American College of Physicians ethics manual states, ?Because it is deceptive, physicians or nurses should not perform half-hearted resuscitation efforts (?slow codes?).? A leading textbook calls slow codes ?dishonest, crass dissimulation, and unethical.? A medical sociologist describes them as ?deplorable, dishonest and inconsistent with established ethical principles.? Nevertheless, we believe that slow codes may be appropriate and ethically defensible in situations in which cardiopulmonary resuscitation (CPR) is likely (...)
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  3. Agency and Authenticity: Which Value Grounds Patient Choice?Daniel Brudney & John Lantos - 2011 - Theoretical Medicine and Bioethics 32 (4):217-227.
    In current American medical practice, autonomy is assumed to be more valuable than human life: if a patient autonomously refuses lifesaving treatment, the doctors are supposed to let him die. In this paper we discuss two values that might be at stake in such clinical contexts. Usually, we hear only of autonomy and best interests. However, here, autonomy is ambiguous between two concepts—concepts that are tied to different values and to different philosophical traditions. In some cases, the two values (that (...)
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  4.  16
    Pediatric Participation in Medical Decision Making: Optimized or Personalized?Maya Sabatello, Annie Janvier, Eduard Verhagen, Wynne Morrison & John Lantos - 2018 - American Journal of Bioethics 18 (3):1-3.
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  5.  11
    The Authority of the Clinical Ethicist.David J. Casarett, Frona Daskal & John Lantos - 1998 - Hastings Center Report 28 (6):6.
  6.  12
    Why Are There So Few Ethics Consults in Children’s Hospitals?Brian Carter, Manuel Brockman, Jeremy Garrett, Angie Knackstedt & John Lantos - 2018 - HEC Forum 30 (2):91-102.
    In most children’s hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians (...)
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  7.  26
    Sequencing Newborns: A Call for Nuanced Use of Genomic Technologies.Josephine Johnston, John D. Lantos, Aaron Goldenberg, Flavia Chen, Erik Parens & Barbara A. Koenig - 2018 - Hastings Center Report 48 (S2):S2-S6.
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  8.  57
    The Doctor-Patient Relationship in the Post-Managed Care Era.G. Caleb Alexander & John D. Lantos - 2006 - American Journal of Bioethics 6 (1):29 – 32.
    The growth of managed care was accompanied by concern about the impact that changes in health care organization would have on the doctor-patient relationship. We now are in a “post-managed care era,” where some of these changes in health care delivery have come to pass while others have not. A re-examination of the DPR in this setting suggests some surprising results. Rather than posing a new and unprecedented threat, managed care was simply the most recent of numerous strains on the (...)
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  9.  21
    Introducing Clinical Ethics Consultation Service in Malaysia: A SWOT Analysis.Erwin Jiayuan Khoo, Siew Houy Chua, Meow-Keong Thong, Bin Alwi Zilfalil & John Lantos - 2019 - Clinical Ethics 14 (1):26-32.
    Clinical ethics consultation service remains undeveloped in developing countries. It is recognised that its introduction poses challenges. Malaysia, a multicultural society with diverse religions, values and perceptions further complicate the introduction of formal clinical ethics consultation service. Clinicians attending a national congress workshop completed a Strengths–Weaknesses–Opportunities–Threats analysis. The aim was to gain insight into clinician’s expectations and promote initiatives leading to the introduction of clinical ethics consultation service. Clinicians agree that clinical ethics consultation service can improve quality of care, reduce (...)
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  10.  35
    Community Equipoise and the Architecture of Clinical Research.Jason H. T. Karlawish & John Lantos - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (4):385-.
    Equipoise is an essential condition to justify a clinical trial. The term, describes a state of uncertainty: the data suggest but do not prove a drug's safety and efficacy The only way to resolve this uncertainty is further study In many cases, a clinical trial seems to be the most efficient way to prove safety and efficacy Equipoise is therefore not an esoteric philosophic construct applied to research ethics. Rather, since it is vital for the justification of clinical trials, it (...)
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  11.  67
    Are Newborns Morally Different From Older Children?Annie Janvier, Karen Lynn Bauer & John D. Lantos - 2007 - Theoretical Medicine and Bioethics 28 (5):413-425.
    Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal (...)
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  12.  23
    Differing Thresholds for Overriding Parental Refusals of Life-Sustaining Treatment.Hannah Gerdes & John Lantos - 2020 - HEC Forum 32 (1):13-20.
    When should doctors seek protective custody to override a parent’s refusal of potentially lifesaving treatment for their child? The answer to this question seemingly has different answers for different subspecialties of pediatrics. This paper specifically looks at different thresholds for physicians overriding parental refusals of life-sustaining treatment between neonatology, cardiology, and oncology. The threshold for mandating treatment of premature babies seems to be a survival rate of 25–50%. This is not the case when the treatment in question is open heart (...)
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  13.  11
    Our suffering and the suffering of our time.John D. Lantos - 2020 - Theoretical Medicine and Bioethics 41 (4):197-201.
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  14.  41
    Rethinking Professional Ethics in the Cost-Sharing Era.G. Caleb Alexander, Mark A. Hall & John D. Lantos - 2006 - American Journal of Bioethics 6 (4):W17-W22.
    Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care or traditional indemnity insurance. Historically, there have been two distinct bases for arguing that physicians should not consider costs in their clinical decisions?an ?aspirational ethic? that exhorts physicians to treat all patients the same regardless of their ability to pay, and an ?agency ethic? that calls on physicians to (...)
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  15.  8
    Healthcare Organizations and High Profile Disagreements.Bryanna Moore & John D. Lantos - 2020 - Bioethics 34 (3):281-287.
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  16.  5
    Death and the Neonate.Bryanna Moore & John D. Lantos - 2021 - Journal of Medical Ethics 47 (4):227-228.
    Dominic Wilkinson suggests that one of Schubert’s songs has relevance for neonatologists today. In the song, Schubert suggests that death sometimes comes as a friend. Wilkinson ponders whether the song has a message for doctors and parents, who sometimes struggle to figure out whether death is an enemy or a friend to a dying baby. Wilkinson reflects on the case of baby ‘Hal’, who was born with serious cardiomyopathy. Hal’s parents and doctors disagree about whether to withdraw life-support. Through his (...)
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  17.  8
    Intractable Disagreements About Futility.John Lantos - 2018 - Perspectives in Biology and Medicine 60 (3):390-399.
    It used to be futile to try to save babies born at 23 weeks. It isn’t anymore. It used to be futile to try to keep patients with end-stage congestive heart failure alive. It isn’t anymore. Futility is a moving target. Thus, it is not surprising that doctors, patients, and families often disagree about which treatments are efficacious or futile, appropriate or inappropriate, obligatory or obligatorily withheld. The goalposts keep moving. Yesterday’s impossibility is today’s routine. Why should a patient believe (...)
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  18.  19
    What We Do When We Resuscitate Extremely Preterm Infants.Jeremy R. Garrett, Brian S. Carter & John D. Lantos - 2017 - American Journal of Bioethics 17 (8):1-3.
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  19.  12
    Community Equipoise and the Architecture of Clinical Research.Jason H. T. Karlawish & John Lantos - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (4):385-396.
    Equipoise is an essential condition to justify a clinical trial. The term, describes a state of uncertainty: the data suggest but do not prove a drug's safety and efficacy The only way to resolve this uncertainty is further study In many cases, a clinical trial seems to be the most efficient way to prove safety and efficacy Equipoise is therefore not an esoteric philosophic construct applied to research ethics. Rather, since it is vital for the justification of clinical trials, it (...)
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  20.  5
    SUPPORT and the Ethics of Study Implementation: Lessons for Comparative Effectiveness Research From the Trial of Oxygen Therapy for Premature Babies.John D. Lantos & Chris Feudtner - 2015 - Hastings Center Report 45 (1):30-40.
  21.  44
    Vaccine Mandates Are Justifiable Because We Are All in This Together.John D. Lantos & Mary Anne Jackson - 2013 - American Journal of Bioethics 13 (9):1 - 2.
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  22.  7
    Do We Still Need Doctors?John D. Lantos - 1997 - Routledge.
    Written with poignancy and compassion, Do We Still Need Doctors? is a personal account from the front lines of the moral and political battles that are reshaping America's health care system. Using compelling firsthand experiences, clinical vignettes, and moral arguments, John D. Lantos, a pediatrician, asks whether, as we proceed with the redesign of our health care system, doctors will -- or should -- continue to fulfill the roles and responsibilities that they have in the past. Interspersing moving personal stories (...)
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  23.  26
    Sequencing Newborns: A Call for Nuanced Use of Genomic Technologies.Josephine Johnston, John D. Lantos, Aaron Goldenberg, Flavia Chen, Erik Parens, Barbara A. Koenig, Members of the Nsight Ethics & Policy Advisory Board - forthcoming - Zygon.
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  24.  14
    On Cultural Sanctions for Shaping Our Children's Genitalia.John Lantos - 2010 - American Journal of Bioethics 10 (9):55-57.
  25.  6
    Muddled Measures of Risks and Misremembered Reasons.John D. Lantos & Chris Feudtner - 2015 - Hastings Center Report 45 (3):4-5.
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  26.  27
    Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians.Michael J. Deem, Mark Christopher Navin & John D. Lantos - 2018 - JAMA Pediatrics 172 (6):515-516.
    A recent American Academy of Pediatrics (AAP) clinical report states that it is an acceptable option for pediatric care clinicians to dismiss families who refuse vaccines. This is a clear shift in guidance from the AAP, which previously advised clinicians to “endeavor not to discharge” patients solely because of parental vaccine refusal. While this new policy might be interpreted as encouraging or recommending dismissal of vaccine-refusing families, it instead expresses tolerance for diverse professional approaches. This is unlike the earlier guidance, (...)
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  27.  7
    Special Care Medical Decisions at the Beginning of Life.John Lantos - 1986
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  28.  22
    Fragile Lives with Fragile Rights: Justice for Babies Born at the Limit of Viability.Manya J. Hendriks & John D. Lantos - 2018 - Bioethics 32 (3):205-214.
    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 (...)
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  29.  35
    Genomic Contraindications for Heart Transplantation.Danton S. Char, Gabriel Lázaro-Muñoz, Aliessa Barnes, David Magnus, Michael J. Deem & John D. Lantos - 2017 - Pediatrics 139 (4).
  30.  9
    Best Interest, Harm, God’s Will, Parental Discretion, or Utility.John D. Lantos - 2018 - American Journal of Bioethics 18 (8):7-8.
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  31.  17
    Special Care: Medical Decisions at the Beginning of Life. Fred Frohock.John Lantos - 1988 - Ethics 98 (2):405-407.
  32.  13
    Informed Consent for Comparative Effectiveness Research Should Not Consider the Risks of the Standard Therapies That Are Being Studied as Risks of the Research.John D. Lantos - 2017 - Journal of Law, Medicine and Ethics 45 (3):365-374.
    There is a debate at the highest levels of government about how to classify the risks of research studies that evaluate therapies that are in widespread use. Should the risks of those therapies be considered as risks of research that is designed to evaluate those therapies? Or not? The Common Rule states, “In evaluating risks and benefits, the IRB should consider only those risks and benefits that may result from the research.” ). By contrast, the Office of Human Research Protections, (...)
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  33.  4
    What We Talk About When We Talk About Ethics.John D. Lantos - 2014 - Hastings Center Report 44 (s1):S40-S44.
  34.  8
    Treatment Decisions for Babies with Trisomy 13 and 18.Isabella Pallotto & John D. Lantos - 2017 - HEC Forum 29 (3):213-222.
    Many babies with trisomy 13 and 18 die in the first year of life. Survivors all have severe cognitive impairment. There has been a debate among both professionals and parents about whether it is appropriate to provide life-sustaining interventions to babies with these serious conditions. On one side of the debate are those who argue that there is no point in providing invasive, painful, and expensive procedures when the only outcomes are either early death or survival with severe cognitive impairment. (...)
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  35.  27
    It's Not the Growth Attenuation, It's the Sterilization!John Lantos - 2010 - American Journal of Bioethics 10 (1):45-46.
  36.  24
    Should Pediatric Patients Be Prioritized When Rationing Life-Saving Treatments During the COVID-19 Pandemic.Ryan M. Antiel, Farr A. Curlin, Govind Persad, Douglas B. White, Cathy Zhang, Aaron Glickman, Ezekiel J. Emanuel & John Lantos - 2020 - Pediatrics 146 (3):e2020012542.
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  37.  32
    The Karamazov Complex: Dostoevsky and DNR Orders.Martha M. Montello & John D. Lantos - 2002 - Perspectives in Biology and Medicine 45 (2):190-199.
  38.  14
    Costs and End-of-Life Care in the NICU: Lessons for the MICU?John D. Lantos & William L. Meadow - 2011 - Journal of Law, Medicine and Ethics 39 (2):194-200.
    Neonatal intensive care units (NICUs) and medical intensive care units (MICUs) are both very expensive. The cost-effectiveness of NICUs has been extensively evaluated, as has the long-term outcomes of subpopulations of NICU patients. NICU treatment is among the most cost-effective of high-tech interventions. And most patients do well. There are fewer evaluations of cost-effectiveness in the MICU and almost no long-term outcome studies. Policymakers who scrutinize expensive high-tech interventions would do well to study the examples found in the NICU.
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  39.  40
    Innovation in Human Research Protection: The AbioCor Artificial Heart Trial.E. Haavi Morreim, George E. Webb, Harvey L. Gordon, Baruch Brody, David Casarett, Ken Rosenfeld, James Sabin, John D. Lantos, Barry Morenz, Robert Krouse & Stan Goodman - 2006 - American Journal of Bioethics 6 (5):W6-W16.
  40.  12
    The Linares Affair.John D. Lantos, Steven H. Miles & Christine K. Cassel - 1989 - Journal of Law, Medicine and Ethics 17 (4):308-315.
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  41.  14
    Do Patients Want to Participate in Decisions About Their Own Medical Care?John D. Lantos - 2015 - American Journal of Bioethics 15 (10):1-2.
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  42.  14
    The Linares Affair.John D. Lantos, Steven H. Miles & Christine K. Cassel - 1989 - Journal of Law, Medicine and Ethics 17 (4):308-315.
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  43. Confessions of a Medicine Man: An Essay in Popular Philosophy (Review).John D. Lantos - 2001 - Perspectives in Biology and Medicine 44 (1):132-134.
  44.  3
    Costs and End-of-Life Care in the NICU: Lessons for the MICU?John D. Lantos & William L. Meadow - 2011 - Journal of Law, Medicine and Ethics 39 (2):194-200.
    Providing care for a baby born at 24 weeks of gestation in a neonatal intensive care unit is one of the most expensive medical treatments in the United States today. The cost can easily run over $300,000 for one baby. Furthermore, many extremely premature babies who survive are left with chronic diseases or disabilities that require further medical expenses and other specialized services throughout childhood or throughout life. When all these expenditures are totaled up, it can seem that neonatal intensive (...)
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  45. Ethics Committees and Resource Allocation.John D. Lantos - 1994 - Bioethics Forum 10:27-29.
  46.  2
    Medical Ethics Through the Star Trek Lens.James Hughes & John Lantos - 2001 - Literature and Medicine 1 (20):26-38.
    Star Trek scripts have often grappled with dilemmas of medical ethics. The most explicitly medical-ethics-oriented Star Trek episode is named, aptly enough, “Ethics.” The script was written by Sara Charno and Stuart Charno, authors of two other Star Trek episodes. “Ethics” first aired on 2 March 1992. In the fall of 1992, we began to use this “Ethics” episode to motivate discussions in our first-year medical students’ course on medical ethics and the doctor-patient relationship. We asked students to write essays (...)
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  47.  88
    Thirteen Ways of Looking at Henrietta Lacks.John D. Lantos - 2016 - Perspectives in Biology and Medicine 59 (2):228-233.
    What are we to make of Henrietta Lacks? After dying at a young age more than half a century ago, she has now become immortal twice—once biologically, and once culturally.She was first immortalized when cells from her cervical biopsy were cultured and became the first immortal cell line. The idea that this made Lacks herself immortal illustrates the dangerous temptations of genetic reductionism and literary license. Such literary license is illustrated by the title of Rebecca Skloot’s remarkable 2011 bestselling book (...)
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  48.  11
    The Weird Divergence of Ethics and Regulation With Regard to Informed Consent.John D. Lantos - 2013 - American Journal of Bioethics 13 (12):31-33.
  49.  26
    Does Pediatrics Need its Own Bioethics?John D. Lantos - 2010 - Perspectives in Biology and Medicine 53 (4):613-624.
  50.  12
    Seeking Justice for Priscilla.John Lantos - 1996 - Cambridge Quarterly of Healthcare Ethics 5 (4):485.
    I am currently caring for a child named Priscilla who is ventilator-dependent and whose care confronted me with questions of justice. Priscilla was born at the County Hospital after a normal pregnancy to a 17-year-old single mother. At birth, she was noted to have some dysmorphic features: widely spaced eyes, low-set ears, and a cleft palate. Her chest X-ray showed hypoplastic ribs and scapulae. Her chromosome studies were normal. Eventually, a diagnosis of a rare dwarfing syndrome campomelic dysplasia – was (...)
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