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‘Good’ Medicine: Ethics and Pediatric Critical Care

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Book cover Intensive Care in Childhood

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 25))

Abstract

In a recent study of 16 pediatric intensive care units (PICU), in the United States, Levetown and her associates reported that every unit systematically restricted medical intervention for particular groups of patients [1]. In their examination of 5415 consecutive PICU admissions, the care of 119 patients was restricted; 79% of these patients subsequently died in the PICU. This group of ’restriction’ patients that died represented 38% of all deaths in the study settings.

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References

  1. Levetown M, Pollack MM, Cuerdon TT, Ruttiman UE, Glover J J (1994) Limitations and withdrawals of medical intervention in pediatric critical care. Journal of the American Medical Association 272:1271–1275.

    Article  PubMed  CAS  Google Scholar 

  2. Fox RC (1994) The entry of U.S. bioethics into the 1990s: A sociological analysis. In: Du- Bose ER, Hamel RP, O’Connell LJ (eds) A matter of principles? Ferment in US bioethics. Trinity Press International, Valley Forge, Pennsylvania, pp.21–71.

    Google Scholar 

  3. Fox RC (1990) The evolution of American bioethics: A sociological perspective. In: Weisz G (ed), Social science perspectives on Medical Ethics. Kluwer Academic, Boston, pp. 201–217.

    Chapter  Google Scholar 

  4. Engelhardt HT (1986) The foundations of bioethics. Oxford University Press, New York.

    Google Scholar 

  5. Beauchamp TL, Childress JF (1994) Principles of biomedical ethics, 4th edn. Oxford University Press, New York.

    Google Scholar 

  6. DuBose ER, Hamel RP, O’Connell LJ (eds) (1994) A matter of principles? Ferment in US bioethics. Trinity Press International, Valley Forge, Pennsylvania.

    Google Scholar 

  7. Kennedy Institute of Ethics Journal: Special issue (1995) Theories and methods in bioethics: Principlism and its critics. Kennedy Institute of Ethics Journal 5:181–286.

    Google Scholar 

  8. Schneider CE (1994) Bioethics and the language of the law. Hastings Center Report 24:16-22.

    PubMed  CAS  Google Scholar 

  9. American Academy of Pediatrics - Committee on Bioethics (1994) Guidelines on forgoing life-sustaining medical treatment. Pediatrics 93:532–536.

    Google Scholar 

  10. Faden RR, Beauchamp TL (1986) A history and theory of informed consent. Oxford University Press, New York.

    Google Scholar 

  11. Pearlman RA, Miles SH, Arnold RM (1993) Contributions of empirical research to medical ethics. Theoretical Medicine 14;197–210.

    Article  PubMed  CAS  Google Scholar 

  12. Uhlmann RF, Pearlman RA, Cain KC (1988) Ability of physicians and spouses to predict resuscitation preferences of elderly patients. Journal of Gerontology 43:115–121.

    Google Scholar 

  13. Veatch RM (1989) Death, dying, and the biological revolution. Yale University Press, New Haven.

    Google Scholar 

  14. Gillett G (1990) Consciousness, the brain and what matters. Bioethics 4:181–198.

    Article  PubMed  Google Scholar 

  15. Ashwal S, Cranford R, Bernat JL et al (The Multi-Society Task Force on Persistent Vegetative State) (1994) Medical aspects of the persistant vegetative state. The New England Journal of Medicine 330:1499–1508; & 330:1572–1579.

    Google Scholar 

  16. Cassell EJ (1991) The nature of suffering and the goals of medicine. Oxford University Press, New York.

    Google Scholar 

  17. Carnevale FA (1991) High technology and humanity in intensive care: finding a balance. Intensive Care Nursing 7: 23–27.

    Article  PubMed  CAS  Google Scholar 

  18. Carnevale FA (1995) The experience of critically ill children. L’infirmiere du Quebec 3:21 (abst).

    Google Scholar 

  19. Carnevale FA (1995) The experience of families of critically ill children: Family system transitions. Canadian Psychology 36:233 (abst).

    Google Scholar 

  20. Carnevale FA (1990) A description of stressors and coping strategies among parents of critically ill children - a preliminary study. Intensive Care Nursing 6:4–11.

    Article  PubMed  CAS  Google Scholar 

  21. Spiro ME (1993) Is the Western conception of the self’peculiar’ within the context of the world cultures? Ethos 21:107–153.

    Article  Google Scholar 

  22. Carnevale FA (1995) “I want to help people:” Ethics, nursing, and critical care. Official Journal of the Canadian Association of Critical Care Nurses 6:10–11.

    Google Scholar 

  23. Taylor KM (1988) Physicians and the disclosure of undesirable information. In: Lock M, Gordon D (eds) Biomedicine examined. Kluwer Academic Publishers, Dordrecht, 441–463.

    Chapter  Google Scholar 

  24. Kaufert JM, O’Neil JD (1990) Biomedical rituals and informed consent: Native Canadians and the negotiation of clinical trust. In: Weisz G (ed), Social science perspectives on Medical Ethics. Kluwer Academic, Boston, 41–63.

    Chapter  Google Scholar 

  25. Gordon DR (1990) Embodying illness, embodying cancer. Culture, Medicine, and Psychiatry 14:275–297.

    CAS  Google Scholar 

  26. Lock M (1995) Contesting the natural in Japan: Moral dilemmas and technologies of dying. Culture, Medicine and Psychiatry 19:1–38.

    Article  PubMed  CAS  Google Scholar 

  27. Taffet GE, Teasdale TA, Luchi RJ (1988) In-hospital cardiopulmonary resuscitation. Journal of The American Medical Association 260:2069–2072.

    Article  PubMed  CAS  Google Scholar 

  28. Murphy DJ (1988) Do-not-resuscitate orders: Time for reappraisal in long-term-care institutions. Journal of The American Medical Association 260:2098–2101.

    Article  PubMed  CAS  Google Scholar 

  29. Schiedermayer DL (1988) The decision to forgo CPR in the elderly patient. Journal of The American Medical Association 260:2096–2097.

    Article  PubMed  CAS  Google Scholar 

  30. Youngner SJ (1988) Who defines futility? Journal of The American Medical Association 260:2094–2095.

    Article  PubMed  CAS  Google Scholar 

  31. Weijer C, Elliott C (1995) Pulling the plug on futility. British Medical Journal 310:683–684.

    Article  PubMed  CAS  Google Scholar 

  32. Vernon DD, Dean JM, Timmons OD, Banner W, Allen-Webb EM (1993) Modes of death in the pediatric intensive care unit: Withdrawal and limitation of supportive care. Critical Care Medicine 21:1798–1802.

    Article  PubMed  CAS  Google Scholar 

  33. Jayes RL, Zimmerman JE, Wagner DP, Draper EA, Knaus WA (1993) Do-not-resuscitate orders in the intensive care units. Journal of The American Medical Association 270:2213–2217.

    Article  PubMed  CAS  Google Scholar 

  34. American Medical Association (1991) Guidelines for the appropriate use of do-not-resuscitate orders. Journal of The American Medical Association 265:1868–1871.

    Article  Google Scholar 

  35. American Hospital Association. (1994) Values in conflict: Resolving ethical issues in health care. American Hospital Association, Chicago.

    Google Scholar 

  36. Callahan D (1983) On feeding the dying. Hastings Center Report 13:22.

    PubMed  CAS  Google Scholar 

  37. Seigler M, Weisbard AJ (1985) Against the emerging stream: Should fluids and nutritional support be discontinued? Archives of Internal Medicine 145:129–131.

    Article  Google Scholar 

  38. Lynn J, Childress JF (1983) Must patients always be given food and water? Hastings Center Report 13:17–21.

    PubMed  CAS  Google Scholar 

  39. de Wachter MAM (1992) Euthanasia in the Netherlands. Hastings Center Report 22:23–30.

    Article  PubMed  Google Scholar 

  40. Singer P (1995) A report from Australia: The legalisation of voluntary euthanasia in the northern territory. Bioethics 9:419–436.

    Article  PubMed  Google Scholar 

  41. Callahan D (1992) When self-determination runs amok. Hastings Center Report 22:52–55.

    Article  PubMed  CAS  Google Scholar 

  42. Capron AM (1992) Euthanasia in the Netherlands: American observations. Hastings Center Report 22:30–33.

    PubMed  CAS  Google Scholar 

  43. Moulin DE, Latimer EJ, Macdonald N, et al (1994) Statement on euthanasia and physician- assisted suicide. Journal of Palliative Care 10:80–81.

    PubMed  CAS  Google Scholar 

  44. Ad Hoc Committee of the Harvard Medical School (to Examine the Definition of Brain Death) (1968) A definition of irreversible coma. Journal of The American Medical Association 205:85–88.

    Article  Google Scholar 

  45. Veatch RM (1993) The impending collapse of the whole-brain definition of death. Hastings Center Report 23:18–24.

    PubMed  CAS  Google Scholar 

  46. Walters JW (1991) Anencephalic infants as organ sources. Bioethics 5:326–341.

    Article  PubMed  Google Scholar 

  47. Arnold RM, Youngner SJ (eds) (1993) Ethical, psychosocial, and public policy implications of procuring organs from non-heart-beating cadavers (special issue). Kennedy Institute of Ethics Journal 3:103–278.

    Google Scholar 

  48. Teo B (1991) Organs for transplantation: The Singapore experience. Hastings Center Report 21:10–13.

    Article  PubMed  CAS  Google Scholar 

  49. Rix BA (1990) The importance of knowledge and trust in the definition of death. Bioethics 4:232–236.

    Article  PubMed  Google Scholar 

  50. Cushman R, Holm S. (1990) Death, democracy and public ethical choice. Bioethics 4:237–252.

    Article  PubMed  Google Scholar 

  51. Hoshino K (1993) Legal status of brain death in Japan: Why many Japanese do not accept ’brain death’ as a definition of death. Bioethics 7:234–238.

    Article  PubMed  Google Scholar 

  52. Ohnuki-Tierney E (1994) Brain death and organ transplantation: Cultural bases of medical technology. Current Anthropology 35:233–254.

    Article  PubMed  Google Scholar 

  53. Lock M, Honde C (1990) Reaching consensus about death: Heart transplants and cultural identity in Japan. In: Weisz G (ed) Social science perspectives on medical ethics. Kluwer Academic Publishers, Dordrecht, p.99–119.

    Chapter  Google Scholar 

  54. Fabrega H (1990) An ethnomedical perspective of medical ethics. Journal of Medicine and Philosophy 15:593–625.

    PubMed  Google Scholar 

  55. Fox RC, Swazey JP (1984) Medical morality is not bioethics - Medical ethics in China and the United States. Perspectives in Biology and Medicine 27:336–360.

    PubMed  CAS  Google Scholar 

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Authors
  1. F. A. Carnevale
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Editor information

Editors and Affiliations

  1. Dept. of Pediatric Surgery, Pediatric Surgical Intensive Care Unit, Sophia Children’s Hospital, University Hospital Rotterdam, Dr. Molewaterplein 60, NL-3015, GJ Rotterdam, The Netherlands

    Dick Tibboel

  2. Dept. of Pediatrics, Subdivision of Pediatric, Intensive Care, Sophia Children’s Hospital, University Hospital Rotterdam, Dr. Molewaterplein 60, NL-3015, GJ Rotterdam, The Netherlands

    Edwin van der Voort

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© 1996 Springer-Verlag Berlin Heidelberg

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Carnevale, F.A. (1996). ‘Good’ Medicine: Ethics and Pediatric Critical Care. In: Tibboel, D., van der Voort, E. (eds) Intensive Care in Childhood. Update in Intensive Care and Emergency Medicine, vol 25. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80227-0_40

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  • DOI: https://doi.org/10.1007/978-3-642-80227-0_40

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-80229-4

  • Online ISBN: 978-3-642-80227-0

  • eBook Packages: Springer Book Archive

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