Hypoplastic left heart syndrome: a paradigm case for examining conscientious objection in pediatric practice.

摘要

The debate about the degree to which a physician's "conscientious objection" to requested care should be honored has tended to focus on 2 areas of medical practice: reproductive health care, especially the rights of women to information about contraception and abortion, and end-of-life care, especially practices that hasten death such as voluntary euthanasia, terminal sedation, and physician assisted suicide. The consequences of conscientious objection take on greater salience in the end-of-life care debate when the focus shifts from practices that hasten death to the examination of policies and practices about informing and offering palliative care as an alternative option to the provision of aggressive life-prolonging measures. Three articles published in Archives of Pediatrics and Adolescent Medicine in September 2008 use the example of infants born with hypoplastic left heart syndrome (HLHS) to examine the obligations physicians have to inform parents about the option for forgoing life-prolonging surgery.