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Cover image of Neonatal Bioethics
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Neonatal Bioethics

The Moral Challenges of Medical Innovation

John D. Lantos, M.D., and William L. Meadow, M.D., Ph.D.

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Neonatal intensive care has been one of the most morally controversial areas of medicine during the past thirty years. This study examines the interconnected development of four key aspects of neonatal intensive care: medical advances, ethical analysis, legal scrutiny, and econometric evaluation.

The authors assert that a dramatic shift in societal attitudes toward newborns and their medical care was a stimulus for and then a result of developments in the medical care of newborns. They divide their analysis into three eras of neonatal intensive care. The first, characterized by the rapid...

Neonatal intensive care has been one of the most morally controversial areas of medicine during the past thirty years. This study examines the interconnected development of four key aspects of neonatal intensive care: medical advances, ethical analysis, legal scrutiny, and econometric evaluation.

The authors assert that a dramatic shift in societal attitudes toward newborns and their medical care was a stimulus for and then a result of developments in the medical care of newborns. They divide their analysis into three eras of neonatal intensive care. The first, characterized by the rapid advance of medical technology from the late 1960s to the Baby Doe case of 1982, established neonatal care as a legitimate specialty of medical care, separate from the rest of pediatrics and medicine. During this era, legal scholars and moral philosophers debated the relative importance of parental autonomy, clinical prognosis, and children's rights.

The second era, beginning with the Baby Doe case (a legal battle that spurred legislation mandating that infants with debilitating birth defects be treated unless the attending physician deems efforts to prolong life "futile"), stimulated efforts to establish a consistent federal standard on neonatal care decisions and raised important moral questions concerning the meaning of "futility" and of "inhumane" treatment. In the third era, a consistent set of decision-making criteria and policies was established. These policies were the result of the synergy and harmonization of newly agreed upon ethical principles and newly discovered epidemiological characteristics of neonatal care.

Tracing the field's recent history, notable advances, and considerable challenges yet to be faced, the authors present neonatal bioethics as a paradigm of complex conversation among physicians, philosophers, policy makers, judges, and legislators which has led to responsible societal oversight of a controversial medical innovation.

Reviews

Reviews

With neonatology as a case study, they take us well beyond the confines of this new field to examine broader issues in medical innovation... Insightful and thought provoking.

An engaging history and philosophical analysis... A clearly written reflection that has broad implications and insights for all of medicine.

There are not too many bioethical books that successfully unite philosophical competence in ethical judgment with seasoned medical expertise. This... is one of them.

Recommended.

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About

Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
192
ISBN
9780801890895
Illustration Description
9 b&w illus., 9 line drawings
Table of Contents

Acknowledgments
1. Overview and Introduction
2. Some Facts about Infant Mortality and Neonatal Care
3. The Era of Innovation and Individualism, 1965–1982
4. The Era of Exposed Ignorance, 1982–1992
5. The

Acknowledgments
1. Overview and Introduction
2. Some Facts about Infant Mortality and Neonatal Care
3. The Era of Innovation and Individualism, 1965–1982
4. The Era of Exposed Ignorance, 1982–1992
5. The End of Medical Progress, 1992 to the Present
6. Economics of the NICU
7. Four Discarded Moral Choices
8. The Possibility of Moral Progress
Notes
Index

Author Bios
Featured Contributor

John D. Lantos, M.D.

John D. Lantos, M.D., is a professor of pediatrics at the University of Chicago and holds the John B. Francis Chair in Bioethics at the Center for Practical Bioethics in Kansas City. He is the author of The Lazarus Case: Life-and-Death Issues in Neonatal Intensive Care (Johns Hopkins University Press, 2001).
Featured Contributor

William L. Meadow, M.D., Ph.D.

William L. Meadow, M.D., Ph.D., is a board-certified neonatologist with twenty-five years of experience in neonatal intensive care and a professor of pediatrics and medicine and co-chief of neonatology at the University of Chicago.