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Shared medical decision‐making: considering what options to present based on an ethical analysis of the treatment of brain tumors in very young children
Author(s) -
Levine Deena,
Cohen Kenneth,
Wendler David
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24189
Subject(s) - medicine , neurocognitive , paternalism , context (archaeology) , dilemma , bioethics , radiation therapy , radiosurgery , intensive care medicine , psychiatry , surgery , cognition , paleontology , philosophy , genetics , epistemology , political science , law , biology
Abstract The treatment of brain tumors in very young children poses both a therapeutic challenge and a bioethical quandary. The administration of craniospinal radiation after surgery offers the greatest chance for cure but causes severe neurocognitive damage. As a result, current practice does not offer parents the option of full‐dose postoperative craniospinal radiation. Some may regard this approach as inappropriate medical paternalism, while others may consider it an example of responsible therapeutics. Evaluation of this dilemma reveals principles which can guide clinicians in determining which treatment options to present to their patients or surrogates, in the context of shared medical decision‐making. Pediatr Blood Cancer 2012;59:216–220. © 2012 Wiley Periodicals, Inc.