Parental Refusal of Surgery in an Infant With Tricuspid Atresia

We present a case of a fetal diagnosis of tricuspid atresia (TA). The pregnant woman and her husband requested that the baby be treated with only palliative care. The cardiologist did not think it would be appropriate to withhold life-prolonging surgery once the infant was born. The neonatologist ar...

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Bibliographic Details
Published inPediatrics (Evanston) Vol. 138; no. 5
Main Authors Kon, Alexander A, Patel, Angira, Leuthner, Steven, Lantos, John D
Format Journal Article
LanguageEnglish
Published United States 01.11.2016
Subjects
Cardiac Surgical Procedures - adverse effects
Cardiac Surgical Procedures - methods
Decision Making
Female
Gestational Age
Humans
Male
Parents - psychology
Pregnancy
Pregnancy Outcome
Treatment Refusal - ethics
Tricuspid Atresia - diagnostic imaging
Tricuspid Atresia - surgery
Ultrasonography, Prenatal - methods
Withholding Treatment - ethics
Young Adult
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Summary:We present a case of a fetal diagnosis of tricuspid atresia (TA). The pregnant woman and her husband requested that the baby be treated with only palliative care. The cardiologist did not think it would be appropriate to withhold life-prolonging surgery once the infant was born. The neonatologist argued that outcomes for TA are similar to those for hypoplastic left heart syndrome, and the standard practice at the institution was to allow parents to choose surgery or end-of-life care for those infants. The team requested an ethics consultation to assist in determining whether forgoing life-prolonging interventions in this case would be ethically supportable. In this article, we ask a pediatric intensivist, a pediatric cardiologist, and a neonatologist to discuss the ethics of withholding life-sustaining treatment of a baby with TA.
ISSN:1098-4275
DOI:10.1542/peds.2016-1730