Abstract
A prenatal diagnosis of ductal-dependent, complex congenital heart disease was made in a fetus with trisomy 18. The parents requested that the genetic diagnosis be excluded from all medical and surgical decision-making and that all life-prolonging therapies be made available to their infant. There was conflict among the medical team about what threshold of neonatal benefit could outweigh maternal and neonatal treatment burdens. A prenatal ethics consultation was requested.
Keywords:
cardiac surgery; decision-making; ethics; trisomy 18.
MeSH terms
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Abortion, Eugenic
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Animals
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Cesarean Section / ethics
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Chromosomes, Human, Pair 18 / genetics*
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Cooperative Behavior
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Cost of Illness
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Double Outlet Right Ventricle / diagnosis*
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Double Outlet Right Ventricle / genetics*
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Double Outlet Right Ventricle / therapy*
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Echocardiography
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Ethics Consultation
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Ethics, Medical*
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Female
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Fetal Death
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Fetal Growth Retardation / diagnosis
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Heart Ventricles / abnormalities*
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Humans
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Infant, Newborn
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Interdisciplinary Communication
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Life Support Care / ethics
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Parental Consent / ethics
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Pregnancy
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Prenatal Diagnosis / ethics*
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Religion and Medicine
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Risk Assessment
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Treatment Refusal
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Trisomy*
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Ultrasonography, Prenatal