Abstract:
:In this article we explore decision-making about treatment when a child faces a life-threatening illness but conventional treatment presents substantial risk and uncertain benefit. When is it acceptable for parents to decide to use complementary and alternative medicine as an alternative, rather than a complement, to conventional care? We use the example of a young child suffering from progressive glycogen storage disease, for whom liver transplant offers the only prospect of a cure. Without a liver transplant, the disease usually results in death within a few years. However, experience using transplant to treat this illness has been limited, success is far from ensured, and the risks (including death and continued progression of the disease) are substantial. The child's parents, who are first-generation immigrants, consider the risks of the transplant unjustified because it still does not offer good prospects for a healthy future. They believe that traditional Chinese medicine could help remediate their daughter's disease. In the article we (1) review parents' obligation to make treatment decisions in the best interests of their child, (2) explain limits on parents' decision-making authority, (3) explore how "best interests" are determined, focusing on cases of serious illness for which conventional treatment is risky and benefit is possible but uncertain, (4) explain the standard of care that physicians must meet in advising about treatment, and (5) outline factors that clinicians and parents should take into account when making decisions.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Gilmour J,Harrison C,Asadi L,Cohen MH,Aung S,Vohra Sdoi
10.1542/peds.2010-2720Fsubject
Has Abstractpub_date
2011-11-01 00:00:00pages
S175-80eissn
0031-4005issn
1098-4275pii
128/Supplement_4/S175journal_volume
128 Suppl 4pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::The recognition of fabricated illness (FI) in a child represents a diagnostic challenge. The suspicion of FI often arises from the discrepancy between laboratory tests and clinical history. For instance, (unnecessary) insulin injections by caregivers has been widely described as a common cause of factitious hypoglycem...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-4165
更新日期:2015-11-01 00:00:00
abstract::Neonatal necrotizing enterocolitis (NEC) remains an important cause of morbidity and mortality among very low birth weight infants. It has long been suspected that intestinal microbes contribute to the pathogenesis of NEC, but the details of this relationship remain poorly understood. Recent advances in molecular biol...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2009-3149
更新日期:2010-04-01 00:00:00
abstract::Initial reports of congenital Zika virus (ZIKV) infection focused on microcephaly at birth with severe brain anomalies; the phenotype has broadened to include microcephaly that develops after birth and neurodevelopmental sequelae. In this narrative review, we summarize medical literature describing motor abnormalities...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2017-2038F
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Children with chronic abdominal pain of nonorganic origin, termed functional abdominal pain (FAP), experience school absences and social withdrawal and report impaired physical ability. The aim of this study was to assess patients' and parents' perceptions of health-related quality of life (QoL) for children ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-0114
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To determine whether state booster seat laws were associated with decreased fatality rates in children 4 to 7 years of age in the United States. METHODS:Retrospective, longitudinal analysis of all motor vehicle occupant crashes involving children 4 to 7 years of age identified in the Fatality Analysis Report...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-1058
更新日期:2012-12-01 00:00:00
abstract::Splenic function in sickle hemoglobinopathy syndromes was assessed to determine the developmental pattern of splenic dysfunction. Nonvisualization of the spleen using technetium-99 metastable (99mTc) spleen scans correlated strongly with pocked (vesiculated) RBCs greater than or equal to 3.5%. Cross-sectional analysis...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:Previous research reported that breast milk lactic acid (LA) levels increase after lactating women complete a bout of exhaustive exercise, resulting in poor infant acceptance of the postexercise breast milk. This highly publicized finding may not apply to more practical, everyday exercise conditions of lactat...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章
doi:10.1542/peds.109.4.585
更新日期:2002-04-01 00:00:00
abstract::Acute acetaminophen intoxication was studied in the dog to characterize pathogenesis and in the mouse as a model for antidotal research. In the dog, overt toxicity was manifested principally by cyanosis, facial and paw edema, gastrointestinal disturbance, and coma. Typical laboratory findings were methemoglobinemia, h...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract::Population-based data on varicella complications are presented using information both from national sample surveys of hospitalizations and physician office visits and from reviews of medical records for all cases occurring within one community (Olmsted County, Minnesota) during a specified period. Acute cerebellar ata...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:Increasing numbers of parents use alternative vaccination schedules that differ from the recommended childhood vaccination schedule for their children. We sought to describe national patterns of alternative vaccination schedule use and the potential "malleability" of parents' current vaccination schedule choi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-0400
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:Neonatal thrombocytopenia occurs commonly in neonatal intensive care units. The role of the thrombopoietin (Tpo) system in normal neonatal platelet regulation and neonatal thrombocytopenia is not well understood. The purpose of our study was to: 1) determine the normal Tpo level at birth in healthy nonthromb...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.105.6.1286
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Prelicensure studies of diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated polio virus vaccine suggested that there were higher rates of fever after its administration than when its component antigens were given separately. METHODS:We conducted an open, controlled, cohort study to evaluate s...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-1977
更新日期:2008-12-01 00:00:00
abstract::Unrecognized congenital hypothyroidism leads to mental retardation. Newborn screening and thyroid therapy started within 2 weeks of age can normalize cognitive development. The primary thyroid-stimulating hormone screening has become standard in many parts of the world. However, newborn thyroid screening is not yet un...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2006-0915
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:With the widespread implementation of intrapartum antibiotic prophylaxis (IAP), the rate of early-onset neonatal sepsis and meningitis caused by Streptococcus agalactiae (group B streptococcus [GBS]) has decreased dramatically, especially in term infants. However, cases of GBS disease continue to occur despi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-2275
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To assess the effects of procedural techniques, local anesthetic use, and postgraduate training level on lumbar puncture (LP) success rates. METHODS:In this prospective observational study, medical students and residents ("trainees") reported techniques used for infant LPs in an urban teaching emergency depa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-0519
更新日期:2006-03-01 00:00:00
abstract::A 1-year-old boy was admitted to the hospital with Haemophilus influenzae meningitis. On the second hospital day a heart murmur heard on admission seemed louder. No signs of congestive heart failure were present. An echocardiogram demonstrated a persistent echo-dense mass behind the anterior leaflet of the mitral valv...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::The following is the winning submission from the Fourth Annual Section on Pediatric Trainees Essay Competition. This year's competition was informed by the 2019-2020 Section on Pediatric Trainees Advocacy Campaign: Protect Kids - Trainees for Firearm Safety. We asked writers to share their experiences as pediatric tra...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2020-015974
更新日期:2020-10-01 00:00:00
abstract::The bilirubin titration point--the lowest bilirubin concentration at which loosely bound bilirubin could be demonstrated by Sephadex gel filtration--was determined in samples collected before, during, and on completion of 17 exchange transfusions as well as in the discarded and donor blood. The bilirubin titration poi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-06-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to: 1) determine the incidence of biphasic reactions in children with anaphylaxis; 2) establish what risk factors can predict progression to a biphasic reaction; and 3) assess the utility of inpatient observation for patients whose anaphylaxis appears to have resolved. METH...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.106.4.762
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:Consensus recommendations state that a radiographic skeletal survey is mandatory for all children <2 years of age with concern for physical abuse. It has been suggested that patients with burns may represent a special subgroup at lower risk for occult fractures, compared with other abused children. Our object...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-1478
更新日期:2010-02-01 00:00:00
abstract::The risk of respiratory and other illnesses in children (age groups: 6 weeks through 17 months, 18 through 35 months, and 36 through 59 months) in various types of day-care facilities was studied. Children considered exposed to day care were those who were enrolled in day care with at least one unrelated child for at ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:Patient registries can effectively collect data over a long period of time to provide a better understanding of the typical presentation of specific conditions. The autism spectrum disorders (ASDs) have experienced a marked increase in reported prevalence over the past 20 years for reasons that are not comple...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-2851E
更新日期:2016-02-01 00:00:00
abstract::Very little is known about the alcohol elimination rates of newborns who have had chronic alcohol exposure in utero. In these case reports, blood alcohol levels were taken immediately before delivery, at delivery, and postdelivery for 2 mothers who drank alcohol during their pregnancies and 3 single-birth newborns. Ne...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-1400
更新日期:2012-10-01 00:00:00
abstract::In this cross-sectional study, the vision-screening process is described for 8417 children aged 3 to 5 seen for health supervision in a group of 102 pediatric practices in 23 states and Puerto Rico. Three hundred forty children who failed screening (63% of those who failed) were followed up 2 months after initial scre...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1992-05-01 00:00:00
abstract::Children and youth with complex medical issues, especially those with technology dependencies, experience frequent and often lengthy hospitalizations. Hospital discharges for these children can be a complicated process that requires a deliberate, multistep approach. In addition to successful discharges to home, it is ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-0606
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:We examined the association between type of child care, participation in different types of child care in the year before kindergarten and the likelihood of obesity at the start of kindergarten. METHODS:Using a nationally representative sample of 15 691 first-time kindergartners from the Early Childhood Long...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-2233
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:The aims of this study were to determine parent and provider knowledge and awareness of newborn screening; to gather opinions from parents, providers, and newborn screening professionals about the content and timing of newborn screening education; and to use consensus data to formulate recommendations and to...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-2633M
更新日期:2006-05-01 00:00:00
abstract::The presence of pulsus paradoxus (PP) in 13 episodes of status asthmaticus in 12 children, ages 13 months to 15 years, was compared sequentially to a clinical score, peak expiratory flow rate (PEFR), heart rate, arterialized capillary pH, carbon dioxide pressure (PCO2), and the ratio of inspired oxygen to oxygen press...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Lyme disease is currently the most frequently reported vector-borne illness in the United States, accounting for more than 95% of such cases. The purpose of this report is to provide recommendations for preventing Lyme disease, including the use of Lyme disease vaccine. Individuals can reduce their risk of Lyme diseas...
journal_title:Pediatrics
pub_type: 指南,杂志文章,实务指引,评审
doi:
更新日期:2000-01-01 00:00:00
abstract::Central line dislodgment in toddlers continues to be a problem. The deployment of a spandex/nylon bodysuit has resulted in eliminating this problem in two overactive toddlers. We highly recommend using this type of garment in appropriate clinical situations. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00