PEDIATRICS Vol. 60 No. 2 August 1977, pp. 197-201
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Todres, I. D.
Right arrow Articles by Shannon, D. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Todres, I. D.
Right arrow Articles by Shannon, D. C.

Pediatricians' Attitudes Affecting Decision-Making in Defective Newborns

I. David Todres M.D.1, Diane Krane J.D.1, Mary C. Howell M.D., Ph.D.1, and Daniel C. Shannon M.D.1

1 Joseph S. Barr Pediatric Intensive Care Unit, Children's Service, and the Department of Anesthesia, Massachusetts General Hospital; and the Departments of Pediatrics and Anaesthesia, Harvard Medical School, Boston

A questionnaire designed to identify the factors that influence the resolution of ethical dilemmas was returned by 230 (57% of the total) Massachusetts pediatricians. The decision to recommend surgery for an infant with Down's syndrome with duodenal atresia when the parents had refused surgery was influenced by religious affiliation (P < .01), religious activity (P < .04), and sex (P = .05). Of those favoring surgery, 40.2% would pursue a court order. The decision to recommend surgery for an infant with severe meningomyelocele when the parents' position was not stated was influenced by age (P < .01), religious activity (P < .02), and specialization (P < .008). When the parents' wishes were expressed, the majority of the pediatricians modified their decision in accord with these wishes. In response to general ethical questions, 79.6% of all pediatricians thought that parents should have the right to withold consent for surgery. Equal numbers thought that psychosocial reasons justified withholding lifesaving procedures. Among a variety of factors, they thought that willingness of the parents to care for the child would influence the decision to take heroic measures. There were 90.4% who thought that ethics should be part of medical education; 55.7% indicated this need throughout their careers.

Submitted on August 19, 1976
Accepted on January 18, 1977




This article has been cited by other articles:


Home page
 PediatricsHome page
R. D. Boss, N. Hutton, L. J. Sulpar, A. M. West, and P. K. Donohue
Values Parents Apply to Decision-Making Regarding Delivery Room Resuscitation for High-Risk Newborns
Pediatrics, September 1, 2008; 122(3): 583 - 589.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. Singh, J. Fanaroff, B. Andrews, L. Caldarelli, J. Lagatta, S. Plesha-Troyke, J. Lantos, and W. Meadow
Resuscitation in the "Gray Zone" of Viability: Determining Physician Preferences and Predicting Infant Outcomes
Pediatrics, September 1, 2007; 120(3): 519 - 526.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
R. J. Boyle
Paradigm Cases in Decision Making for Neonates
NeoReviews, November 1, 2004; 5(11): e477 - e483.
[Full Text] [PDF]

Home page
 PediatricsHome page
W. Meadow, L. Frain, Y. Ren, G. Lee, S. Soneji, and J. Lantos
Serial Assessment of Mortality in the Neonatal Intensive Care Unit by Algorithm and Intuition: Certainty, Uncertainty, and Informed Consent
Pediatrics, May 1, 2002; 109(5): 878 - 886.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. L. Streiner, S. Saigal, E. Burrows, B. Stoskopf, and P. Rosenbaum
Attitudes of Parents and Health Care Professionals Toward Active Treatment of Extremely Premature Infants
Pediatrics, July 1, 2001; 108(1): 152 - 157.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
W. M. Southgate, D. J. Annibale, T. C. Hulsey, and D. M. Purohit
International Experience With Trisomy 21 Infants Placed on Extracorporeal Membrane Oxygenation
Pediatrics, March 1, 2001; 107(3): 549 - 552.
[Abstract] [Full Text]

Home page
 JAMAHome page
M. Rebagliato, M. Cuttini, L. Broggin, I. Berbik, U. de Vonderweid, G. Hansen, M. Kaminski, L. A. A. Kollee, A. Kucinskas, S. Lenoir, et al.
Neonatal End-of-Life Decision Making: Physicians' Attitudes and Relationship With Self-reported Practices in 10 European Countries
JAMA, November 15, 2000; 284(19): 2451 - 2459.
[Abstract] [Full Text] [PDF]

Home page
 J Child NeurolHome page
R. Hermann and K. Mehes
Physicians' Attitudes Regarding Down Syndrome
J Child Neurol, January 1, 1996; 11(1): 66 - 69.
[Abstract] [PDF]

Home page
 J Child NeurolHome page
R. H.A. Haslam and R. Milner
The Physician and Down Syndrome: Are Attitudes Changing?
J Child Neurol, July 1, 1992; 7(3): 304 - 310.
[Abstract] [PDF]

Home page
 J Law Med EthicsHome page
C. Strong
Defective Infants and Their Impact on Families: Ethical and Legal Considerations
J. Law Med. Ethics, September 1, 1983; 11(4): 168 - 172.
[PDF]