Skip to main content
SpringerLink
Log in
Book cover

CAPD/CCPD in Children pp 433–450Cite as

The Ethics of Withholding and Withdrawing Therapy in Infants and Young Children

  • Chapter

Abstract

Writing in the first edition of this book, a decade ago, Ed Kohaut made a prophetic statement. “Aggressive treatment of the young infant with renal insufficiency may stimulate as many emotional, moral and economic issues as it does questions pertinent to medical therapy…”(1).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kohaut EC. CAPD in Infants. In: Fine RN (ed). Chronic Ambulatory Peritoneal Dialysis (CAPD) and Chronic Cycling Peritoneal Dialysis (CCPD) in Children. Boston: Martinus Nijhoff Publishing; 1987:77–86.

    Chapter  Google Scholar 

  2. Blowey, DL, MacFarland K, Alon U, McGraw-Houchens M, Hellerstein S, Warady BA. Peritoneal dialysis in the neonatal period: Outcome data. J Perinatology 1993; 13(1):59–64.

    CAS  Google Scholar 

  3. Neu AM, Warady BA. Dialysis and renal transplantation in infants with irreversible renal failure. Adv Ren Replace Ther 1996; 3(1):48–59.

    PubMed  CAS  Google Scholar 

  4. Coulthard MC, Vernon B. Managing acute renal failure in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1995; 73(3):F187–F192.

    Article  PubMed  CAS  Google Scholar 

  5. Blank RH. Treatment of critically ill newborns in Australia. J Legal Med 1995; 16(2):211–226.

    Article  CAS  Google Scholar 

  6. Fischbach M. Peritoneal dialysis prescription for neonates. Perit Dial Int 1996; 16(Suppl 1):S512–S514.

    PubMed  Google Scholar 

  7. Alarabi AA, Petersson T, Danielson BG, Wikstrom B. Continous peritoneal dialysis in children with acute renal failure. Adv Perit Dial 1994; 10:289–293.

    PubMed  CAS  Google Scholar 

  8. Verrina E, Zacchello G, Perfumo F, Edefonti A, Sorino P, Bassi S, Andreda B, Cattarelli D, Capasso G, Consalvo G. Clinical experience in the treatment of infants with chronic peritoneal dialysis. Adv Perit Dial 1995; 11:281–284.

    PubMed  CAS  Google Scholar 

  9. Kandoth PW, Agarwal GJ, Dharnid harka VR. Acute renal failure in children requiring dialysis therapy. Indian Pediatr 1994; 31(3):305–309.

    PubMed  CAS  Google Scholar 

  10. Ho NK. Ethical issues in neonatal paediatrics — the Singapore perspective. Ann Acad Med Singapore 1995; 24(b)910–914.

    PubMed  CAS  Google Scholar 

  11. Gusmano R, Perfumo F. Worldwide demographic aspects of chronic renal failure in children. Kid Int 1993; 41:531–534.

    Google Scholar 

  12. Duff RS, Campbell AGM. Moral and ethical dilemmas in the special care nursery. New Eng J Med 1973; 289:890–894.

    Article  PubMed  CAS  Google Scholar 

  13. Whitelaw A. Death as an option in neonatal intensive care. Lancet 1986; 2:328–331.

    Article  PubMed  CAS  Google Scholar 

  14. Campbell AGM, Lloyd DJ, Duffty P. Treatment dilemmas in neonatal care: Who should survive and who should decide? Ann N Y Acad Sci 1988; 530:92–103.

    Article  PubMed  CAS  Google Scholar 

  15. Balfour-Lynn IM, Tasker RC. Futility and death in paediatric medical intensive care. J Med Ethics 1996; 22:279–281.

    Article  PubMed  CAS  Google Scholar 

  16. Postlethwaite RJ, Eminson DM, Webb NK, Lewis MA. Conference Report: 26th Annual Conference of the European Working Group on Psychosocial Aspects of Children with Chronic Renal Failure. Pediatr Nephro 1996; 10(2):245.

    Article  CAS  Google Scholar 

  17. Lantos J. Foreword. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). In Ethics and Perinatology. Oxford Medical Publications, New York; 1995. pp v–vi.

    Google Scholar 

  18. Glover J. Causing death and saving lives. Penguin Books. London; 1990.

    Google Scholar 

  19. Rhoden NK. Treating Baby Doe: The ethics of uncertainty. Hastings Cent Rep, 1986; 16:34–42.

    Article  PubMed  CAS  Google Scholar 

  20. Bunchman TE. The ethics of infant dialysis. Proceedings of the VIIth Congress of the ISPD June 18–21, 1995. Perit Dial Int 1996; 16(Supp 1):505–508.

    Google Scholar 

  21. Sartorius N. Ethics of Health Care. Speech to Conference of Geneva Initiative. Zeist, Netherlands, 1997. (unpublished)

    Google Scholar 

  22. Campbell AGM, McHaffie HE. Prolonging life and allowing death: Infants. J Med Ethics 1995;21:339–344.

    Article  PubMed  CAS  Google Scholar 

  23. Thomasma D. Abstract medical knowledge, newborns, and uncertainty; A challenge to philosophy of medicine. In: Goldworth A, Silverman W, Stevenson DR, Young EWD (eds). Ethics and Perinatology. New York: Oxford Medical Publication 1995; Chapter 5B:146–161.

    Google Scholar 

  24. Sinclair J, Torrance G. From probability to preference. In: Goldworth A, Silverman W, Stevenson DR, Young EWD (eds). Ethics and Perinatology. New York: Oxford University Press, 1995; 5A:120–145.

    Google Scholar 

  25. Sauer PJJ. Ethical decisions in neonatal intensive care units: The Dutch experience. Pediatrics, 1992; 90(5):729–732.

    PubMed  CAS  Google Scholar 

  26. The Danish Council of Ethics, 7th Annual Report, 1994. Debate Outline — Extreme Prematurity: Ethical Aspects. Denmark: Thorup Grafik, 1995.

    Google Scholar 

  27. The International Neonatal Network. The CRIB (Clinical Risk Index for Babies) score: A tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. Lancet, 1993; 342:193–198.

    Article  Google Scholar 

  28. Lorber J. Spina bifida cystica. Results of treatment of 270 consecutive cases with criteria for selection for the future. Arch Dis Child, 1972; 47:854.

    Article  PubMed  CAS  Google Scholar 

  29. Kuhse H. Quality of life as a decision-making criterion II. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 4B: 104–119.

    Google Scholar 

  30. Edge R, Groves J. The Ethics of Health Care: A Guide For Clinical Practice. Albany, New York, Publishers, Inc., 1994.

    Google Scholar 

  31. Weir R. Withholding and withdrawing therapy and actively hastening death II. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 6B:172–183.

    Google Scholar 

  32. Stevenson DK, Young EWD. Introduction: A thematic overview. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 1:1–9.

    Google Scholar 

  33. Penticuff JH. Nursing ethics in perinatal care. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 14A:405–426.

    Google Scholar 

  34. Versluys Z, de Leeuw R. A Dutch report on the ethics of neonatal care. J Med Ethics 1995;21(1):14–16.

    Article  PubMed  CAS  Google Scholar 

  35. Fairbairn C. Enforced death: Enforced life. J Med Ethics 1991; 17:144–149.

    Article  PubMed  CAS  Google Scholar 

  36. Sundström P. Peter Singer and “lives not worth living” — comments on a flawed agrument from analogy. J Med Ethics 1995; 21(1):35–38.

    Article  PubMed  Google Scholar 

  37. US Commission on Civil Rights. Medical discrimination against children with disabilities. Washington D.C., US Government Printing Office, 1989.

    Google Scholar 

  38. Frost NC. Medical Futility: Commentary. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 3B:70–81.

    Google Scholar 

  39. Lowe M, Kerridge IH, Mitchell KR. These sorts of people don’t do very well: Race and allocation of health care resources. J Med Ethics 1995; 21:256–360.

    Article  Google Scholar 

  40. Sesso R, Fernandez PF, Anca M, Drummond M, Draibe S, Sigulem D, Ajzen H. Acceptance for chronic dialysis treatment: Insufficient and unequal. Nephrol Dial Transplant 11(6):982–986, 1996.

    Article  PubMed  CAS  Google Scholar 

  41. Stahlman M. Withholding and withdrawing therapy and actively hastening death I. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 6A:162–172.

    Google Scholar 

  42. Harvey B. Financing healthcare for pregnant women and newborns in the US. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press; Chapter 12A:341–354.

    Google Scholar 

  43. Cattermole G, Goheen J. Preface. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; pp vii–vxv.

    Google Scholar 

  44. Goodman N. Resource allocation: Idealism, realism, pragmatism, openness. J Med Ethics 1991; 17:179–180.

    Article  PubMed  CAS  Google Scholar 

  45. Caiman K. The ethics of allocation of scarce health care resources: A view from the centre. J Med Ethics 1994; 20:71–74.

    Article  Google Scholar 

  46. Lewis E. Economics and ethics. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 12B:355–376.

    Google Scholar 

  47. Shooter MS. What a patient can expect from a consultant psychiatrist. Advances in Psychiatric Treatment 1997; 3(2) 119–125.

    Article  Google Scholar 

  48. Sachdeva RC, Jefferson LS, Coss-Bu J, Brody BA. Resource consumption and the extent of futile care among patients in a pediatric intensive care unit setting. J Pediatr 1996; 128(b):742–747.

    PubMed  CAS  Google Scholar 

  49. Grant AJ. Letter comment. Br Medical Journal 1995;311(7017):1437.

    Article  CAS  Google Scholar 

  50. Nelson RM, Nelson LJ. Letter comment. N Engl J Med 1994; 330(2): 145–146.

    PubMed  CAS  Google Scholar 

  51. (Anonymous). Did the NHS fail child B? Nurs Times 1996; 92(36):33–36.

    Google Scholar 

  52. Lazarus J. Heart-rending case in Britian ends in girl’s death (letter). Can Med Assoc J 1996; 155(4):372–374.

    CAS  Google Scholar 

  53. Goldworth A. Conflict in the pediatric setting: Ethical judgement vs parental autonomy. Camb Q Healthc Ethics 1995; 4(1):36–41.

    Article  PubMed  CAS  Google Scholar 

  54. Paris JJ, Schreiber MD. Physicians’ refusal to provide life-prolonging medical interventions (Review). Clin Perinatol 1996;23(3):563–571.

    PubMed  CAS  Google Scholar 

  55. Richmond C. Is the issue the price of a child’s life, or the futility of heroic measures? Can Med Assoc J 1995; 152(12):2036–2036.

    Google Scholar 

  56. Pauly-O’Neill S. Victor or victim in a critical care war? (Editorial). Nursing Spectrum 1995; 5(20):3.

    Google Scholar 

  57. Cramb A. Doctor left my premature daughter to die. Scottish Ccorrespondent. The Daily Telegraph 1997; p.9.

    Google Scholar 

  58. Craig C. On withholding nutrition and hydration in the terminally ill. Has palliative medicine gone too far? J Med Ethics 1994; 20:139–143.

    Article  PubMed  CAS  Google Scholar 

  59. Brazier M. The handicapped infant: Whose rights? Whose decision? In: Medicine, Patients and the Law. Hammondsworth Middlesex, England: Penguin Books 1992.

    Google Scholar 

  60. Yeoh C, Kiely E, Davies H. At the coalface-Unproven treatment in childhood oncology-how far should paediatricians cooperate? J Med Ethics 1994; 20:75–76.

    Article  PubMed  CAS  Google Scholar 

  61. Jonsen AR. Organ transplantation II. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 7B:202–213.

    Google Scholar 

  62. Medical News (1981) 283 British Medical Journal 567 (quoted in Brazier M.) In: Ethics and Perinatology. p314.

    Google Scholar 

  63. Saal HM. Neonatal intensive care as a locus for ethical decisions. Cleft Palate-Cranio 1995; 32(6):500–503.

    Article  CAS  Google Scholar 

  64. (Anonymous). The American Academy of Pediatrics Committee on Bioethics. Ethics and the care of critically ill infants and children (Review). Pediatrics 1996; 98(1):149–152.

    Google Scholar 

  65. Alderson P. Choosing for children: Parents’ consent to surgery. Oxford: Oxford University Press 1990.

    Google Scholar 

  66. McHaffie H, Fowlie P. Life, death and decisions. Doctors and Nurses Reflect on Neonatal Practice. Hale, Cheshire, England: Hochland and Hochland 1996.

    Google Scholar 

  67. Jameton AL. Paediatric nursing ethics. In: Goldworth A, Silverman W, Stevenson DK, Young EWD (eds). Ethics and Perinatology. New York, Oxford University Press, 1995; Chapter 14B:427–443.

    Google Scholar 

  68. Anspach RR. Deciding who lives; Fateful choices in the intensive care nursery. Berkeley: University of California Press, 1993.

    Google Scholar 

  69. Hauerwas S, Bordi R, Burrell DB. Truthfulness and Tragedy: Further Investigations Into Christian Ethics. Notre Dame: University of Notre Dame Press, 1985.

    Google Scholar 

  70. Sulmasy DP, Sugarman J. Are withholding and withdrawing therapy always morally equivalent? J Med Ethics 1994; 20:218–222.

    Article  PubMed  CAS  Google Scholar 

  71. Kuhse H, Singer P. Should the Baby Live? The Problem of Handicapped Infants. (Reprinted) Gregg Rivivals, 1994.

    Google Scholar 

  72. Singer P. Rethinking Life and Death. Oxford: Oxford University Press, 1994.

    Google Scholar 

  73. Stinson R, Stinson P. The Long Dying of Baby Andrew. Boston: Little, Brown, 1983.

    Google Scholar 

  74. Tilden VP, Tolle SW, Gartland MJ, Nelson CA. Decisions about life-sustaining treatment. Impact of physicians’ behaviours on the family. Arch Intern Med 1995; 155:633–638.

    Article  PubMed  CAS  Google Scholar 

  75. General Medical Council: Tomorrows Doctors. London: GMC, 1993.

    Google Scholar 

  76. Seedhouse D, Lovett L. Practical Medical Ethics. Chichester: John Wiley and Sons, 1992.

    Google Scholar 

  77. Dunn P. Point of view. Appropriate care of the newborn; Ethical dilemmas. J Med Ethics 1993; 19:82–84.

    Article  PubMed  CAS  Google Scholar 

  78. Waz WR, Henkind J. The adequacy of medical ethics education in a pediatrics training programme. Acad Med 1995; 70(11):1041–1043.

    Article  PubMed  CAS  Google Scholar 

  79. Holm S, Gjersoe P, Grade G, Hartling O, Ibsen KE, Marcussen H. Ethical reasoning in mixed nurse-physician groups. J Med Ethics 1996; 22:168–173.

    Article  PubMed  CAS  Google Scholar 

  80. Charon R, Brody H, Clark MW, Davis D, Martinez R, Nelson RM. Literature and ethical medicine: 5 cases from common practice. J Med Philos 1996; 21(3):243–265.

    Article  PubMed  CAS  Google Scholar 

  81. Orr RD, Morton KR, De Leon DM, Fals JC. Evaluation of an ethics consultation service: Patient and family prospective. Am J Med 1996; 101(2): 135:141.

    Article  PubMed  CAS  Google Scholar 

  82. McClung JA, Kamer RS, De Luca M, Barber HJ. Evaluation of a medical ethics consultations service: Opinions of patients and health care providers. Am J Med 1996; 100(4):456–460.

    Article  PubMed  CAS  Google Scholar 

  83. Savage TA. The nurses role on ethics committees and as an ethics consultant. Semin Nurse Manag 1994; 2(1):41–47.

    PubMed  CAS  Google Scholar 

  84. Wardle LD. A matter of conscience: Legal protection for the rights of conscience of healthcare providers. Camb Q Healthc Ethics 1993; 2(4):529–542.

    Article  PubMed  CAS  Google Scholar 

  85. Auden WH. Law Like Love. Collected Shorter Poems 1927–2957 (Reprint). London: Faber and Faber Ltd., 1981.

    Google Scholar 

  86. Tyson J. Evidence-based ethics and the care of premature infants (Review). Future Child 1995; 5(1): 197–213.

    Article  PubMed  CAS  Google Scholar 

  87. Re B (1981) 1WLR 1421.

    Google Scholar 

  88. The Times (newspaper report) October 6, 1981.

    Google Scholar 

  89. Legal correspondent. Dr. Leonard Arthur: His trial and its implications. Br Medical Journal 1981;283:1340–1341.

    Google Scholar 

  90. Re C (1989) 2 All E R 782, CA.

    Google Scholar 

  91. Re J (1990) 3 All E R 930, Ca.

    Google Scholar 

  92. Re: Stephen Dawson (1983) 145 DLR 3 ed) 610.

    Google Scholar 

  93. Buchanan P. The Dividing Line. Editorial. New York Times, 1983.

    Google Scholar 

  94. Balcombe J. The child, the doctor and the judge. J R Soc Med 1996; 89(Suppl 28):3–9.

    PubMed  Google Scholar 

  95. Glantz LH. Withholding and withdrawing therapy: The role of the criminal law. Law, Med Health Care 1987–1988; 14(4):231–241.

    Google Scholar 

  96. Clark FI. Intensive care treatment decisions: The roots of our confusion. Pediatrics 1994;94(1):98–101.

    PubMed  CAS  Google Scholar 

  97. National Association for Staff Support. A charter for staff support. London; National Association for Staff Support/Royal College of Nursing, 1992.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Children’s Centre, Abergavenny, Gwent, Wales

    Michael Shooter M.D.

Authors
  1. Michael Shooter M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pediatrics, SUNY at Stony Brook, Stony Brook, New York, USA

    Richard N. Fine M.D. (Professor and Chairman) (Professor and Chairman)

  2. Stanford University Medical Center, Lucille Packard Children’s Hospital At Stanford, Stanford, California, USA

    Steven R. Alexander M.D. (Professor of Pediatrics, Chief, Pediatric Nephrology) (Professor of Pediatrics, Chief, Pediatric Nephrology)

  3. The Children’s Mercy Hospital, Kansas City, Missouri, USA

    Bradley A. Warady M.D. (Professor of Pediatrics, Chief, Section of Pediatric Nephrology) (Professor of Pediatrics, Chief, Section of Pediatric Nephrology)

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer Science+Business Media New York

About this chapter

Cite this chapter

Shooter, M. (1998). The Ethics of Withholding and Withdrawing Therapy in Infants and Young Children. In: Fine, R.N., Alexander, S.R., Warady, B.A. (eds) CAPD/CCPD in Children. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4931-4_24

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-4931-4_24

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7237-0

  • Online ISBN: 978-1-4615-4931-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation