Influence of Prognosis on Decisions Regarding the Care of Newborns With Myelodysplasia
McLaughlin, John F.
Shurtleff, David B.
Lamers, Janice Y.
Hayden, Patricia W.
Kropp, Robert J.
New England Journal of Medicine. 1985 Jun 20; 312(25): 1589-1594.
A multidisciplinary team from the University of Washington Medical Center and the Children's Orthopedic Hospital in Seattle discusses the prognostic criteria used to decide between surgical treatment and supportive care and describes the outcomes of these options in 212 newborns, seen from 1965 to 1982, who were afflicted with meningomyelocele and related disorders. A significant increase in overall survival of aggressively treated infants, irrespective of prognosis, is attributed to improved status on referral, technical advances in treatment, and social changes in attitudes toward the disabled. The authors recommend early surgical care for most newborns, with selection of appropriate treatment to be made after full disclosure to the family of prognosis and of medical, educational, and social options. (KIE abstract)
Allowing to Die; Attitudes; Children; Congenital Disorders; Decision Making; Disclosure; Evaluation; Hospitals; Infants; Institutional Policies; Morbidity; Mortality; Meningomyelocele; Newborns; Parents; Patient Care; Physicians; Prognosis; Selection for Treatment; Socioeconomic Factors; Spina Bifida; Standards; Statistics; Surgery; Withholding Treatment;
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