In a recent essay, George Annas, the legal columnist for The New England Journal of Medicine, observed that the resuscitation of extremely premature infants, even over parental objection, is not problematic because “once the child's medical status has been determined, the parents have the legal authority to make all subsequent decisions.” Annas himself is quick to concede that treatment in a high-technology neonatal intensive care unit frequently takes on a life of its own. He also acknowledges that although bioethicists and (...) courts agree that there is no ethical or legal difference between withholding or withdrawing a respirator from a patient, parents and physicians find the withdrawal much more emotionally troubling. (shrink)

Death in the Clinic fills a gap in contemporary medical education by explicitly addressing the concrete clinical realities about death with which practitioners, patients, and their families continue to wrestle. Visit our website for sample chapters!

When there is a conflict between parents and the physician over appropriate care due to an infant whose decision prevails? What standard, if any, should guide such decisions?This article traces the varying standards articulated over the past three decades from the proposal in Duff and Campbell’s 1973 essay that these decisions are best left to the parents to the Baby Doe Regs of the 1980s which required every life that could be salvaged be continued. We conclude with support for the (...) policy articulated in the 2007 guidelines of the American Academy of Pediatrics on non-intervention or withdrawal of intensive care for high-risk newborns. (shrink)