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Biomedical subjects

N K Rhoden

Publications and source records attributed to N K Rhoden.

7 recordsLinked to original sources
PubMed1988

Perinatal law and ethics rounds.

Advances in perinatal medicine have increased the complexity of the clinical decision-making process. Medical education curricula have paid little attention to exploring the ethical and legal aspects of these decisions. In response to this perceived need, we initiated a case-oriented teaching program in perinatal law and ethics. The goals of the program included the following: to develop skills in "moral diagnosis" and analysis (the ability to interpret and analyze clinical cases from a moral point of view); to understand the relevant laws; to appreciate the ethical and legal relationships between the pregnant woman, her fetus, and the professionals; and to encourage open and frank discussion of these important issues. The teaching rounds, led by a lawyer and ethicist, were held monthly, and included all professionals who care for pregnant women and their newborns. A patient was presented in lay language, stressing the ethical or legal issue raised by the case. Cases could be separated into five categories: questions concerning abortion, issues of maternal-fetal conflict, labor management in extreme prematurity or fetal abnormality, innovative therapy, and the psychological concerns of difficult decisions. Careful case analysis with an in-depth discussion of the ethical principles and legal precedents on which decisions are based appears to be an effective and useful educational exercise. This approach to perinatal teaching can prepare professionals to deal with exigent situations that may occur in practice.

Abortion, Induced↗
PubMed1986

Treating Baby Doe: the ethics of uncertainty.

The ethical tensions inherent in all Baby Doe treatment decisions are compounded by medical uncertainty. Physicians both here and abroad have adopted various strategies. Swedish doctors tend to withhold treatment from the beginning from infants for whom statistical data suggest a grim prognosis. The British are more likely to initiate treatment but withdraw it if the infant appears likely to die or suffer severe brain damage. The trend in the U.S. is to start treating any baby who is potentially viable and continue until it is virtually certain that the infant will die. The "least worst" strategy is an individualized one: starting treatment, gathering data, and then reassessing the decision.

Brain Diseases↗
PubMed1985

Withholding treatment from Baby Doe: from discrimination to child abuse.

Questions surrounding withholding treatment from severely impaired newborns have elicited three significantly different substantive and procedural responses: from the Reagan administration's Department of Health and Human Services through the Carter President's Commission on Ethical Problems, and subsequent congressional legislation on child abuse. Movement from a rigid and simplistic application of medical imperatives to ambiguous and abstract criteria of the child's "best interest" represented limited progress. A new legislative compromise principle is an imperfect but practical accommodation to moral and medical realities.

Advisory Committees↗