Kon Alexander A, Patel Angira, Leuthner Steven, Lantos John D
Naval Medical Center San Diego and the University of California San Diego School of Medicine, San Diego, California.
Lurie Children's Hospital, Chicago, Illinois.
Pediatrics. 2016 Nov;138(5). doi: 10.1542/peds.2016-1730. Epub 2016 Oct 7.
We present a case of a fetal diagnosis of tricuspid atresia (TA). The pregnant woman and her husband requested that the baby be treated with only palliative care. The cardiologist did not think it would be appropriate to withhold life-prolonging surgery once the infant was born. The neonatologist argued that outcomes for TA are similar to those for hypoplastic left heart syndrome, and the standard practice at the institution was to allow parents to choose surgery or end-of-life care for those infants. The team requested an ethics consultation to assist in determining whether forgoing life-prolonging interventions in this case would be ethically supportable. In this article, we ask a pediatric intensivist, a pediatric cardiologist, and a neonatologist to discuss the ethics of withholding life-sustaining treatment of a baby with TA.
我们报告一例胎儿被诊断为三尖瓣闭锁（TA）的病例。该孕妇及其丈夫要求仅对婴儿进行姑息治疗。心脏病专家认为，一旦婴儿出生，不进行延长生命的手术是不合适的。新生儿科医生认为，TA的治疗结果与左心发育不全综合征相似，该机构的标准做法是允许父母为那些婴儿选择手术或临终关怀。该团队请求进行伦理咨询，以协助确定在这种情况下放弃延长生命的干预措施在伦理上是否可行。在本文中，我们邀请一位儿科重症监护专家、一位儿科心脏病专家和一位新生儿科医生讨论对患有TA的婴儿不进行维持生命治疗的伦理问题。
