Worried about her teenage daughter who had been vomiting for several weeks,a relative called Douglas S. Diekema, M.D., M.P.H., FAAP, at home for his advice.

As he usually does in such situations, Dr. Diekema commiserated and advised the mother to take the girl to her f a m ily doctor. “I f o u n d o u t t h r e e months later that the girl was pregnant,” said Dr. Diekema, a member of the AAP Committee on Bioethics. “That did not even come to mind, even though as an emergency room doctor, that would be the first thought I would normally have had.”

He uses the example to explain how difficult it is to be objective when it comes to family and friends. “There are certain things you just can't imagine so you tend not to be as effective,” Dr. Diekema said. “We have preconceived notions...

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