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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Ethics RoundsEthics Rounds

Trisomy 18 and Complex Congenital Heart Disease: Seeking the Threshold Benefit

Renee D. Boss, Kathryn W. Holmes, Janyne Althaus, Cynda H. Rushton, Hunter McNee and Theresa McNee
Pediatrics July 2013, 132 (1) 161-165; DOI: https://doi.org/10.1542/peds.2012-3643
Renee D. Boss
aDepartment of Pediatrics, Johns Hopkins University School of Medicine,
bJohns Hopkins Berman Institute of Bioethics, and
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Kathryn W. Holmes
cDepartment of Pediatrics, Oregon Health and Science University, Portland, Oregon
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Janyne Althaus
aDepartment of Pediatrics, Johns Hopkins University School of Medicine,
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Cynda H. Rushton
bJohns Hopkins Berman Institute of Bioethics, and
dDepartment of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland; and
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Hunter McNee
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Theresa McNee
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Abstract

A prenatal diagnosis of ductal-dependent, complex congenital heart disease was made in a fetus with trisomy 18. The parents requested that the genetic diagnosis be excluded from all medical and surgical decision-making and that all life-prolonging therapies be made available to their infant. There was conflict among the medical team about what threshold of neonatal benefit could outweigh maternal and neonatal treatment burdens. A prenatal ethics consultation was requested.

  • trisomy 18
  • cardiac surgery
  • ethics
  • decision-making
  • Accepted February 25, 2013.
  • Copyright © 2013 by the American Academy of Pediatrics

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Pediatrics
Vol. 132, Issue 1
1 Jul 2013
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Trisomy 18 and Complex Congenital Heart Disease: Seeking the Threshold Benefit
Renee D. Boss, Kathryn W. Holmes, Janyne Althaus, Cynda H. Rushton, Hunter McNee, Theresa McNee
Pediatrics Jul 2013, 132 (1) 161-165; DOI: 10.1542/peds.2012-3643

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Trisomy 18 and Complex Congenital Heart Disease: Seeking the Threshold Benefit
Renee D. Boss, Kathryn W. Holmes, Janyne Althaus, Cynda H. Rushton, Hunter McNee, Theresa McNee
Pediatrics Jul 2013, 132 (1) 161-165; DOI: 10.1542/peds.2012-3643
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  • Article
    • Abstract
    • Case Report
    • The Fetal Medicine Team’s Response
    • Hunter and Theresa McNee, the Parents, Write
    • The Ethics Committee Response
    • Outcome of the Case
    • Summary
    • John D. Lantos Comments
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More in this TOC Section

  • Opioid Management in the Dying Child With Addiction
  • Disagreement About Surgical Intervention in Trisomy 18
  • When a Family Seeks to Exclude Residents From Their Child’s Care
Show more Ethics Rounds

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  • Ethics/Bioethics
    • Ethics/Bioethics
  • Cardiology
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    • Cardiac Surgery

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