By Dominic Wilkinson
In historical Rome mom and dad could seek advice the priestess Carmentis almost immediately after delivery to procure prophecies of the way forward for their baby toddler. this present day, mom and dad and medical professionals of seriously sick kids seek advice a special oracle. Neuroimaging offers a imaginative and prescient of the kid's destiny, quite of the character and severity of any incapacity. in keeping with the result of mind scans and different exams medical professionals and fogeys face heart-breaking judgements approximately even if to proceed extensive remedy or to permit the kid to die.
Paediatrician and ethicist Dominic Wilkinson appears on the profound and contentious moral concerns dealing with those that paintings in in depth care taking good care of seriously sick kids and babies. whilst may still babies or little ones be allowed to die? How actual are predictions of destiny caliber of lifestyles? How a lot say should still mom and dad have in those judgements? How may still they care for uncertainty in regards to the destiny? He combines philosophy, medication and technology to make clear present and destiny dilemmas.
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Extra resources for Death or Disability?: The 'Carmentis Machine' and decision-making for critically ill children
However, some people do want treatment provided even if they were going to be in such a condition. This might be because of vitalism. But it could also be because of the value that they place on the small chance of recovery or improvement to normal function. Even if the chance is tiny it may be worthwhile from their perspective to continue life-sustaining treatment (Stone 2007). We will return shortly to the signiﬁcance of patients’ wishes for treatment decisions in intensive care. However, the important practical question is about what we should allow patients or their surrogate to decide if they do reasonably judge that survival is a worse fate than dying.
In addition, decisions not to treat are hard because they require value judgements about the beneﬁt DESTINY, DISABILITY, AND DEATH 25 of treatment given a particular prognosis, and ethical judgements about decisions that may lead to the death of the patient. There are broadly four different reasons not to provide life-sustaining treatment (LST) for a patient. Quantity of Life The ﬁrst of these is because treatment may sustain life, but not for long. The patient will die whether or not the treatment is given.
The above treatments are in the domain of the intensive care team. It is reasonably uncontroversial that they may, at least in some circumstances, be withheld or withdrawn from critically ill patients. There are other simpler treatments, however, that also make the difference between life and death for some seriously ill patients. Providing oxygen by mask, intravenous ﬂuids through a cannula in the patient’s hand, or food through a tube in the patient’s nose save the lives of patients whose oxygen levels are low, or who cannot drink or eat.
Death or Disability?: The 'Carmentis Machine' and decision-making for critically ill children by Dominic Wilkinson