•  6
    ArgumentsPhysicians who counsel expectant parents about the needs for resuscitation and intensive care for an extremely preterm infant must be able to address many clinical facts and be prepared to face several ethical considerations. Such counseling is generally more than an acquisition of informed consent. It must be guided by ethical principles, values held dear by parents, relational priorities and directed toward an informed and shared decision-making process. Parents may come with a need f…Read more
  •  25
    What We Do When We Resuscitate Extremely Preterm Infants
    with Jeremy R. Garrett and John D. Lantos
    American Journal of Bioethics 17 (8): 1-3. 2017.
  •  3
    Postponed Withholding Does Not Postpone Attachment
    American Journal of Bioethics 22 (11): 27-30. 2022.
    Counseling parents on the cusp of delivering an extremely preterm infant is performed thousands of times every year in North America, Europe, Japan and in centers situated in other countries around...
  •  29
    The Spring 1999 issue of CambridgeQuarterly adds to the growing body of academic inquiry into the goals of neonatal intensive care practices. Muraskas and colleagues thoughtfully presented the possibility of nontreatment for neonates born at or under 24 weeks gestation. Jain, Thomasma, and Ragas explained that quality of future life must not be ignored in clinical deliberation. And Hefferman and Heilig described once again the dilemmas nurses face when caring for potentially devastated neonates …Read more
  •  3
    My Story is Traumatic, You Probably Would Not Understand
    American Journal of Bioethics 22 (5): 58-60. 2022.
    The healthcare ethics consultant holds a widely described role in the modern American hospital. S/he may practice within a clinical discipline and be trained in bioethics, or be a trained phi...
  •  14
    Ethics Consultations in a Fetal Health Center
    with Shika Kalevor
    American Journal of Bioethics 22 (4): 78-80. 2022.
    Fetal medicine is an emerging field that raises unique ethical concerns. Our children’s hospital started a Fetal Health Center 10 years ago. In this specialized setting, a multidisciplinary t...
  •  3
    Handbook of Perinatal and Neonatal Palliative Care
    with Rana Limbo and Charlotte Wool
    Springer. 2020.
    Clinical care for pregnant women and their partners presents ethical dilemmas and value-based decision-making following concerning fetal diagnoses. How can empathic caregivers best support families who are on the path toward a critical juncture of clinical care, human values, the meaning of life and dealing with its finitude? This clinical handbook is the first to address in an extensive and interdisciplinary manner these issues as palliative care may be a considered manner of accompaniment towa…Read more
  • The Lure of Technology: Considerations in Newborns with Technology-Dependence
    with Laura Miller-Smith
    In Annie Janvier & Eduard Verhagen (eds.), Ethical Dilemmas for Critically Ill Babies, Springer Netherlands. pp. 81-91. 2016.
    For a minority of children managed in the NICU, there is a need for more complex technologic assistance in order to sustain life, mitigate a more chronic debilitation from a pervasive life-limiting condition, or provide a bridge from life-sustaining therapy to a more semi-permanent treatment such as organ transplantation. This chapter will address two major types of technology assistance for infants and children—tracheostomy and assisted home ventilation, and dialysis—and the myriad complication…Read more
  •  17
    Why Are There So Few Ethics Consults in Children’s Hospitals?
    with Manuel Brockman, Jeremy Garrett, Angie Knackstedt, and John Lantos
    HEC Forum 30 (2): 91-102. 2018.
    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 physic…Read more
  •  16
    Engaging Pediatric Health Professionals in Interactive Online Ethics Education
    with Diane M. Plantz, Jeremy R. Garrett, Angela D. Knackstedt, Vanessa S. Watkins, and John Lantos
    Hastings Center Report 44 (6): 15-20. 2014.
    Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs…Read more