Has the Emphasis on Autonomy Gone Too Far? Insights from Dostoevsky on Parental Decisionmaking in the NICU

摘要

In a recent essay, George Annas, the legal columnist for The New England Journal of Medicine, observed that the resuscitation of extremely premature infants, even over parental objection, is not problematic because "once the child's medical status has been determined, the parents have the legal authority to make all subsequent decisions." Annas himself is quick to concede that treatment in a high-technology neonatal intensive care unit (NICU) frequently takes on a life of its own. He also acknowledges that although bioethicists and courts agree that there is no ethical or legal difference between withholding or withdrawing a respirator from a patient, parents and physicians find the withdrawal much more emotionally troubling.