Spinal muscular atrophy type I: Do the benefits of ventilation compensate for its burdens?

被引:23
作者
Gray, Kelly [1 ]
Isaacs, David [1 ,2 ]
Kilham, Henry A. [1 ]
Tobin, Bernadette [3 ,4 ]
机构
[1] Childrens Hosp Westmead, Westmead, NSW 2145, Australia
[2] Univ Sydney, Sydney, NSW 2006, Australia
[3] Australian Catholic Univ, Sydney, NSW, Australia
[4] St Vincents Hosp, Plunkett Ctr, Darlinghurst, NSW 2010, Australia
关键词
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.
引用
收藏
页码:807 / 812
页数:6
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