Invited Commentary
July 2012

Balancing the Tension: Parental Authority and the Fear of Paternalism in End-of-Life CareComment on “Confession”

Author Affiliations

Author Affiliations: Pediatric Critical Care Medicine, Treuman Katz Center for Pediatric Bioethics, University of Washington School of Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.

Arch Pediatr Adolesc Med. 2012;166(7):594. doi:10.1001/archpediatrics.2012.556

In “Confession,”1 Dr Humikowski faces a nearly impossible task: to recommend the withdrawal of a mechanical ventilator from a child with a severe and devastating neurological injury while navigating cultural barriers. Although requesting maternal permission to withdraw the ventilator may appear absurd, some doctors feel obligated to request parental permission, influenced by our Westernized value system that prioritizes respect for parental authority in all medical decision making.2 Yet, this perceived obligation is not ethically or legally justified.

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