autonomy;
benefit and burden;
quality of life;
withdrawal of treatment;
D O I:
10.1111/jpc.12386
中图分类号:
R72 [儿科学];
学科分类号:
100202 ;
摘要:
We report the progress of an 8-year-old child with spinal muscular atrophy (SMA) type 1. The parents elected in infancy that the child should be on long-term ventilation, but all attempts to establish this care at home have failed, so the child remains ventilated in the hospital. The leader of the long-term ventilation team reports on the child's progress and describes a week in the child's life. Two paediatricians argue that the benefits of long-term ventilation have not and do not compensate the child for the burdens imposed on her by this treatment and explain why they would not support the withdrawal of long-term ventilation now. They argue that long-term ventilation might have been avoided by applying to a court of law when the child was an infant. An ethicist discusses ethical aspects of decision-making in SMA type 1.
机构:
Neurosci Res Australia, Randwick, NSW 2031, Australia
Univ New S Wales, Sydney Childrens Hosp, Sch Womens & Childrens Hlth, Dept Neurol, Sydney, NSW, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
Farrar, Michelle A.
Vucic, Steve
论文数: 0引用数: 0
h-index: 0
机构:
Neurosci Res Australia, Randwick, NSW 2031, Australia
Univ Sydney, Westmead Hosp, Western Clin Sch, Dept Neurol, Sydney, NSW 2006, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
Vucic, Steve
Johnston, Heather M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ New S Wales, Sydney Childrens Hosp, Sch Womens & Childrens Hlth, Dept Neurol, Sydney, NSW, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
Johnston, Heather M.
du Sart, Desiree
论文数: 0引用数: 0
h-index: 0
机构:
Murdoch Childrens Res Inst, Victorian Clin Genet Serv, Mol Genet Lab, Parkville, Vic, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
du Sart, Desiree
Kiernan, Matthew C.
论文数: 0引用数: 0
h-index: 0
机构:
Neurosci Res Australia, Randwick, NSW 2031, Australia
Univ New S Wales, Prince Wales Clin Sch, Sydney, NSW, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Tassie, Benjamin
Isaacs, David
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia
Sydney Childrens Hosp Network, Dept Infect Dis & Microbiol, Sydney, NSW, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Isaacs, David
Kilham, Henry
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia
Childrens Hosp Westmead, Sydney Childrens Hosp Network, Dept Gen Med, Sydney, NSW, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Kilham, Henry
Kerridge, Ian
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia
Royal N Shore Hosp, Dept Haematol & Transfus Med, Sydney, NSW, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
机构:
Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, NetherlandsUniv Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Wadman, Renske I.
Bosboom, Wendy M. J.
论文数: 0引用数: 0
h-index: 0
机构:
Sint Lucas Andreas Hosp, Dept Neurol, Amsterdam, NetherlandsUniv Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Bosboom, Wendy M. J.
van der Pol, W. Ludo
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
van der Pol, W. Ludo
van den Berg, Leonard H.
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
van den Berg, Leonard H.
Wokke, John H. J.
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Wokke, John H. J.
Iannaccone, Susan T.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Texas SW Med Ctr Dallas, Dept Pediat, Dallas, TX 75390 USAUniv Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Iannaccone, Susan T.
Vrancken, Alexander F. J. E.
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Vrancken, Alexander F. J. E.
[J].
COCHRANE DATABASE OF SYSTEMATIC REVIEWS,
2012,
(04):
机构:
Neurosci Res Australia, Randwick, NSW 2031, Australia
Univ New S Wales, Sydney Childrens Hosp, Sch Womens & Childrens Hlth, Dept Neurol, Sydney, NSW, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
Farrar, Michelle A.
Vucic, Steve
论文数: 0引用数: 0
h-index: 0
机构:
Neurosci Res Australia, Randwick, NSW 2031, Australia
Univ Sydney, Westmead Hosp, Western Clin Sch, Dept Neurol, Sydney, NSW 2006, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
Vucic, Steve
Johnston, Heather M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ New S Wales, Sydney Childrens Hosp, Sch Womens & Childrens Hlth, Dept Neurol, Sydney, NSW, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
Johnston, Heather M.
du Sart, Desiree
论文数: 0引用数: 0
h-index: 0
机构:
Murdoch Childrens Res Inst, Victorian Clin Genet Serv, Mol Genet Lab, Parkville, Vic, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
du Sart, Desiree
Kiernan, Matthew C.
论文数: 0引用数: 0
h-index: 0
机构:
Neurosci Res Australia, Randwick, NSW 2031, Australia
Univ New S Wales, Prince Wales Clin Sch, Sydney, NSW, AustraliaNeurosci Res Australia, Randwick, NSW 2031, Australia
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Tassie, Benjamin
Isaacs, David
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia
Sydney Childrens Hosp Network, Dept Infect Dis & Microbiol, Sydney, NSW, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Isaacs, David
Kilham, Henry
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia
Childrens Hosp Westmead, Sydney Childrens Hosp Network, Dept Gen Med, Sydney, NSW, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Kilham, Henry
Kerridge, Ian
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
Univ Sydney, Sydney Med Sch, Sydney, NSW 2006, Australia
Royal N Shore Hosp, Dept Haematol & Transfus Med, Sydney, NSW, AustraliaUniv Sydney, Ctr Values Eth & Law Med, Sydney, NSW 2006, Australia
机构:
Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, NetherlandsUniv Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Wadman, Renske I.
Bosboom, Wendy M. J.
论文数: 0引用数: 0
h-index: 0
机构:
Sint Lucas Andreas Hosp, Dept Neurol, Amsterdam, NetherlandsUniv Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Bosboom, Wendy M. J.
van der Pol, W. Ludo
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
van der Pol, W. Ludo
van den Berg, Leonard H.
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
van den Berg, Leonard H.
Wokke, John H. J.
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Wokke, John H. J.
Iannaccone, Susan T.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Texas SW Med Ctr Dallas, Dept Pediat, Dallas, TX 75390 USAUniv Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Iannaccone, Susan T.
Vrancken, Alexander F. J. E.
论文数: 0引用数: 0
h-index: 0
机构:Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, NL-3584 CG Utrecht, Netherlands
Vrancken, Alexander F. J. E.
[J].
COCHRANE DATABASE OF SYSTEMATIC REVIEWS,
2012,
(04):