PEDIATRICS Vol. 73 No. 4 April 1984, pp. 564-566
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Early Management and Decision Making for the Treatment of Myelomeningocele: A Critique

JOHN M. FREEMAN MD1

1 Birth Defects Treatment Center, The Johns Hopkins Hospital, Baltimore

In a recent article, Gross et al1 have set out to do something about early decision making and the management of children with myelomeningocele. They have set out to evaluate a program that they have developed, claim is workable, and claim addresses the present ethical dilemma surrounding this issue. Have they done something worthwhile? Have they done it well?

First, let us look at what they have done. Of 68 babies with myelomeningocele, they have selected 33 babies (48%) for supportive care only. Twenty-six families accepted the team's recommendation and left their child in a special children's shelter. Of these babies, 24 died (mean 37 days). Two babies were treated later at the parents' request.