This month’s Ethics Rounds, entitled “Beyond the Question: Reexamining a Parent’s Unusual Request,” by Dr. Katharine Callahan and colleagues at the Children’s Hospital of Philadelphia (10.1542/peds.2023-064954) focuses on an unexpected parental request. The patient was born at 23 weeks and experienced several complications due to his prematurity. He is now 3 months old and consistently improving. His father, who lives in another country and has never seen his son in person, unexpectedly calls and requests that mechanical ventilation be withdrawn and care be redirected from curative to comfort-only care. The attending neonatologist asks the social worker to schedule a family meeting to convey that comfort-only care is not ethically permissible given the patient’s current clinical status and prognosis.
How would you have responded if you were the neonatologist? Commentaries by a neonatologist, a clinical ethicist, and a conflict mediator highlight different aspects of the case and offer helpful suggestions. Aliza Narva, JD, MSN, RN, for example, analyzes the potential role of the attending’s and the father’s implicit biases and draws on trauma-informed care to encourage providers to ask “What happened to this person?” instead of “What is wrong with this person?”
Read this month’s Ethics Rounds and see what you think. How do you generally respond to surprises, and did you find the commentators’ recommendations helpful? I know that I do not always respond optimally when I am surprised and am trying to be more inquisitive before responding.
